多排螺旋CT在肝硬化个肝叶灌注成像中的临床价值

Clinical value of multi-detector CT for lobular perfusion imaging in liver cirrhosis

目的:观察肝硬化不同肝叶血流灌注参数变化的意义。材料与方法:使用SIEMENS somatom 6层螺旋CT对16例肝硬化组及38例正常组于肝门层面行多层动态CT灌注扫描,通过软件处理得到不同肝叶的血流动力学参数:肝血容量(BV)、肝血流量(BF)、平均通过时间(MTT)、肝动脉灌注指数(HAF)、计算得到肝动脉灌注量(HAP)、门静脉灌注量(PVP)、门脉灌注指数(PPI)。采用SPSS13.0软件对组间参数进行方差分析和LSD-t检验,检验水准ɑ=0.05。结果:正常对照组肝左内叶HAF大于肝右叶,PPI小于肝右叶,差异均有统计学意义(p=0.015)。BV、BF、MTT、HAP及PVP在各肝叶间无显著性差异(P>0.05)。肝硬化组BV、BF、MTT、HAP、PVP、HAF、PPI在个肝叶间均未表现出统计学差异(P>0.05)。结论:正常人不同肝叶血流动力学状况不尽相同,肝硬化时不同肝叶间血供差异的现象消失。

Objective：To dertermine the significance of parameters changes in lobular perfusion imaing in liver cirrhosis. Methods：SIEMENS somatom 6 multi-slice CT was used in 16 cases of liver cirrhosis and 58 healthy individuals. The hepatic blood volume （BV）, hepatic blood flow （bfburkina）, the average transit time （MTT）, transarterial index （HAF）, the transarterial （HAP）, intraportal （PVP）, portal-in-place index （PPI） were then determined with software. The SPSS15.0 was employed for statistical analysis. Results：In the normal controls, the HAF was significantly higher but PPI lower in the left lobe than in the right one （P〈0.05）. In the patients, there were no marked differences in BV, BF, MTT, HAP, PVP, HAF and PPI between the left lobe and the right one （P〉0.05）. Conclusion：There is difference in hemodynamics among different liver lobes in normal individuals. However, the changes disappear in patients with liver cirrhosis.