间接性门静脉DSA的时间-视频密度曲线对肝功能状态的评估价值

Time-video density curve of indirect portal vein DSA:its value in assessing the liver function condition

目的初步探讨肝门静脉DSA的时间-视频密度曲线(TVDC)参数对肝功能状态评估的价值。方法收集2007年7月-2008年10月进行介入诊疗的肝癌(HCC)患者42例,其中男35例,女7例,平均年龄56岁(28～76岁),肿块平均10.38 cm(5.5～15.5 cm)。按肝功能Child-Pugh分级将患者分成A组(24例)、B组(11例)和C组(7例)。其中35例经脾动脉插管、7例经肠系膜上动脉插管行间接性肝门静脉造影。利用DSA图像处理软件选定兴趣区(ROI),生成TVDC,取得并对比各参数值(PV、KmaxU、KmaxD、PT)。结果随肝功能分级增加,PV、KmaxU、KmaxD逐渐降低,PT逐渐增加,但三组间PV差异无统计学意义(P>0.05),A组与B组、A组与C组间的KmaxU差异有统计学意义(P<0.01),但在B组与C组间差异无统计学意义(P>0.05)。A组与B组及C组间的KmaxD差异有统计学意义(P<0.01),B组与C组间差异亦有统计学意义(0.01<P<0.05)。结论肝门静脉DSA的TVDC参数可以反映肝功能的变化。

Objective To preliminary evaluate the various parameters of the time-video density curve（TVDC） obtained by indirect portal vein DSA in assessing the liver function condition.Methods A total of 42 patients with hepatocellular carcinoma（35 males and 7 females with a mean age of 56 years）,encountered in author＇s hospital during the period from July 2007 to Oct.2008,were enrolled in this study.Based on the Child-Pugh hepatic function classification,the patients were divided into group A（n = 24）,group B（n = 11） and group C（n = 7）.Indirect portal vein angiography was performed in all patients via splenic artery（n = 35） or superior mesenteric artery（n = 7） catheterization.Region of interest（ROI） was selected with the help of DSA image processing software,and the TVDC was obtained.Various parameter values,including PV,KmaxU,KmaxD and PT,were determined.A paired t′-test was used for statistical analysis.The results were analyzed and compared among three groups.Results With the increase of liver function grade,PV,KmaxU and KmaxD showed a reduction,while PT was increased gradually.Nevertheless,no significant difference in PV values existed among the three groups（P 0.05）.Statistically significant difference in KmaxU existed between group A and group B as well as between group A and group C（P 0.01）,while the difference in KmaxU was not significant between group B and group C（P 0.05）.The difference in KmaxD was significant between group A and group B（P 0.01） as well as between group A and group C（P 0.01）,and also between group B and group C（0.01 P 0.05）.Conclusion The parameters of the time-video density curve（PV,KmaxU,KmaxD and PT） obtained from indirect portal vein DSA can approximately reflect the variations of the liver function condition.