螺旋CT灌注成像技术在肝纤维化中的临床观察

The clinical observation on spiral CT perfusion imaging in patients with hepatic fibrosis

目的:观察螺旋CT灌注成像技术在肝脏纤维化中的价值,探讨相应参数的特征及临床意义,以积累临床经验,指导临床工作。方法:收集79例经肝穿证实为肝纤维化的患者作为观察组,并选择18例非肝脏疾病的志愿者作为对照组,均行肝脏CT灌注扫描,获得主要灌注参数,即肝动脉灌注量(HAP)、门静脉灌注量(PVP)、总肝灌注量(TLP)、肝动脉灌流指数(HPI)、肝血流量(HBF)及血容量(BV)。结果:观察组患者分期,S1期17例,S2期20例,S3期20例,S4期22例。观察组中PVP、TLP、HBF和BV值明显低于对照组,而HPI值明显高于对照组。观察组中PVP、TLP、HBF及BV在S3和S4期中的值明显低于S1和S2期,而HPI在S3和S4期中的值明显高于S1和S2期。结论:CT灌注成像能很好地反映肝纤维化的血管分布情况,对早期诊断、鉴别诊断及临床分期有重要价值。

Objective： To observe the value of spiral CT perfusion imaging in patients with hepatic fibrosis, for accumulating clinical experience in directing the clinical work. Methods： 79 patients with hepatic fibrosis confirmed by liver biopsy were selected as observation group, 18 non-hepatic disease patients were selected as control group. We studied the charac - teristics of spiral CT perfusion imaging of HAP, PVP, TLP, HPI, HBF and BV. Results： 17 cases were S1 stage, 20 cases were S2 stage, 20 cases were S3 stage, 22 cases were S4 stage in the observation group. The PVP, TLP, HBF and BV were lower in observation group than those in control group. The HPI was higher in observation group than that in control group. The PVP, TLP, HBF and BV were lower in S3-S4 stage than those in S1-S2 stage. The HPI was higher in S3-S4 stage than that in S1-S2 stage. Conclusion： Hepatic perfusion imaging with spiral CT can reflect vascularity in patients with hepatic fibrosis. It should be worthy of being recommended in the early diagnosis, differential diagnosis and clinical stages.