慢性肝病患者CT血流灌注与肝纤维化血清指标相关性探讨

Evaluation of CT perfusion to liver fibrosis and cirrhosis and the correlation with serum indicator

目的:探讨肝脏纤维化及早期肝硬化患者CT血流灌注参数与肝纤维化血清指标的相关性。方法:使用GE64层螺旋CT灌注技术计算40例经病理证实不同分期肝纤维化患者及10例正常对照人群肝血流量(blood flow,BF)、肝血容积(blood volume,BV)、肝动脉血流(hepatic arteral fraction,HAF)、平均通过时间(mean transit time,MTT)、表面通透性(permeability surface,PS)等血流动力学参数,同时检测肝纤维化血清学指标:血清Ⅲ型胶原(typeIII,procolla-gen peptide)、透明质酸(hyaluronic,HA)、层粘蛋白(laminin,LN)、Ⅳ型胶原(collagen,CIV),并与病理结果对照。结果:自肝炎到早期肝硬化阶段,S0,S2,S4期的HAF呈升高趋势,BV和BF都升高,MTT缩短,PS降低。在不同时期BV、BF、HAF和MTT的差异有统计学意义。血清学指标HA、LN、胶原IV、胶原III及CT灌注指标BV、BF、MTT、PS、HAF之间,除HA与MTT、PS与LN,MTT与IV型胶原呈负相关,其余各指标间均呈正相关。结论:肝脏血流动力学微循环变化反映了肝纤维化及早期肝硬化的病理过程。

Objective：To evaluate the correlation of hepatic perfusion with multi-slice spiral CT and several serum markers in the diagnosis of liver fibrosis and cirrhosis.Methods：CT perfusion parameters of blood flow（BF）,blood volume（BV）,hepatic arteral fraction（HAF）,mean transit time（MTT）,permeability surface（PS） along with the serum fibrosis markers： procollagen peptide（typeIII）,hyaluronic（HA）,laminin（LN）,IV collagen were achieved and compared in different groups proved by pathology.Results：CT perfusion parameters had significant differences in control and different fibrosis groups,BV,BF and HAF were increasing while MTT shorten and PS decrease with fibrosic degree.HA was inverse correlation with MTT and PS with LN,MTT with collagen IV,other perfusion parameters were direct correlation with serum indicators.Conclusion：CT perfusion parameters can reflect the deposition of collogen and the change of microcirculation.