320排容积CT全肝灌注成像模式的初步应用

Preliminary Study of Whole Liver Perfusion Imaging with 320 Slice Volume CT

目的应用320排容积CT全肝灌注模式,探讨正常肝脏的CT灌注血流特征,为肝脏疾病的灌注成像提供理论依据。方法 75名经临床证实的健康自愿者,采用320排CT动态容积扫描模式行CT全肝灌注检查,将数据导入Abdomen perfusion软件对全肝进行灌注分析,分别测量肝脏各段的肝动脉灌注量(HAP)、门静脉灌注量(HPP)、动脉灌注分数(APF),分析肝脏各段间及左、右半肝血流灌注的差异。结果肝脏Ⅰ～Ⅷ段HAP、HPP、APF差异均有统计学意义(HAP:F=2.773,P=0.008;HPP:F=4.659,P=0.000;APF:F=4.681,P=0.000)。肝脏Ⅰ段HAP与除Ⅲ段之外的肝段差异具有统计学意义(P<0.05),肝脏Ⅲ段HPP与肝脏其他各段差异具有统计学意义(P<0.05),肝脏Ⅰ、Ⅲ段APF与Ⅴ、Ⅵ、Ⅷ段差异具有统计学意义(P<0.05)。左半肝与右半肝HPP、APF差异有统计学意义(P=0.042,P=0.008)。结论应用320排CT全肝灌注模式可直观反映及准确地评价肝脏整体各段及左、右半肝血流灌注特征。全肝各段及左、右半肝的血流灌注情况不尽相同,可能与肝血管解剖特点有关,可以为肝脏疾病的灌注研究提供正常基准。

Objective To study the blood flow perfusion charateristics of normal liver using the pattern of whole liver perfusion with 320 Slice Volume CT. Methods 75 cases of clinically proven healthy volunteers received dynamic en- hanced 320 slice Volume CT, and the data were transferred into abdomen perfusion software, and the hepatic arterial perfu- sion （HAP）, hepatic portal perfusion （HPP）, arterial perfusion fraction （APF） of the whole hepatic segments were calculat- ed, and then perfusion parameters were analyzed. Results There were significantly different on HAP, HPP,APF among hepatic segments ] - V~ （ HAP： F = 2. 773, P = 0. 008 ; HPP： F = 4. 659, P = 0. 000 ; APF： F = 4. 681, P = 0. 000）. HAP was significantly different between segment ] and the other hepatic segments except segment]lI （P 〈 0.05 ）. HPP was signif- icantly different between segment HI and the other hepatic segments （ P 〈 0.05 ）. APF was significantly different between segments I , 11I and segments V, VI, VDI（P 〈 0.05）. HPP, APF were significantly different between left lobe and right lobe （ P = 0. 042,P = 0. 008）. Conclusion The whole liver perfusion pattern with 320 slice CT can be used to accurately evaluate the perfusion conditions in all hepatic segments. The difference of peffusion among the whole hepatic segments and difference between left lobe and right lobe are related with anatomy of the liver vessels, which provide CT perfusion informa- tion for study of hepatic disease.