第二代双源CT对肝脏八段灌注成像的特点

Features of Eight Segments of Liver Perfusion with the Second Generation Dual-source Computed Tomography

目的采用第2代双源CT灌注方法探讨肝脏灌注成像中各肝段的血流灌注特征。方法 15例低血糖查因的患者行第2代双源CT腹部灌注扫描,得到肝脏灌注图像,经肝脏灌注软件处理后分别测量肝脏各段的肝动脉灌注量、门静脉灌注量、肝脏灌注指数,分析肝脏各段间血流灌注的差异。结果肝脏Ⅲ、Ⅳ段肝动脉灌注量与肝脏Ⅴ～Ⅷ段差异具有统计学意义(P<0.05),肝脏Ⅱ段门静脉灌注量与肝脏Ⅵ、Ⅶ段差异具有统计学意义(P<0.05),肝脏Ⅲ段门静脉灌注量与肝脏Ⅴ～Ⅷ段差异具有统计学意义(P<0.05),肝脏Ⅲ段肝动脉灌注指数与肝脏Ⅴ～Ⅷ段差异具有统计学意义(P<0.01)。结论第2代双源CT大螺距往复扫描模式可用于评价全肝各段血流灌注情况,肝脏各段间血流灌注存在一定差异,可能与肝脏血管解剖特点及检查体位有关,其临床意义有待于进一步研究。

Objective To explore the features of eight segments of liver perfusion with the second generation dual-source computed tomography （DSCT）.Methods Totally 15 patients with pancreatic endocrine diseases underwent abdominal CT perfusion with the second generation DSCT.The liver perfusion images were then transferred to workstation,and perfusion parameters were calculated,and then the artery liver perfusion （ALP）,portal-vein liver perfusion （PVP）,and hepatic perfusion index（HPI）of the eight hepatic segments were calculated.Results ALP was significantly different between segments Ⅲ,Ⅳ and segments Ⅴ-Ⅷ （P0.05）.PVP was significantly different between segments Ⅱ and segments Ⅵ,Ⅶ （P0.05）.PVP and HPI were significantly different between segment Ⅲ and segments Ⅴ-Ⅷ （P0.05,P0.01）.Conclusions The second generation DSCT can be used to evaluate the perfusion conditions in all eight hepatic segments.The perfusion differs among eight segments of liver,which may be related with the anatomy of the liver vessels and the position of DSCT scanning.Its clinical significance needs further research.