肝动脉碘分数在不同肝功能分级肝硬化患者中的变化特点

Changes of arterial iodine fraction(AIF) in cirrhotic patients of different Child-Pugh grades

目的探讨应用能谱CT获得的肝动脉碘分数(arterial iodine fraction,AIF)在不同肝功能分级肝硬化患者中的变化规律。方法回顾性选取90例行CT扫描的肝硬化门脉高压的患者作为研究组,采用肝功能Child-Pugh分级标准进行分组,其中Child-A级31例,Child-B级40例,Child-C级19例;回顾性选取18例因临床需要行腹部CT检查、经其他检查证实无肝脏疾病者作为对照组。所有患者均行HD750能谱CT三期扫描。应用能谱分析软件重建出以水和碘为基物质的能量CT图像。在碘基图像上分别测量研究组和对照组动脉期、门静脉期肝实质的碘含量并计算肝动脉碘分数,对两组的AIF行方差分析。结果对照组、肝功能A级、B级及C级研究组的肝动脉碘分数分别为0.24±0.03、0.29±0.09、0.37±0.10、0.48±0.12。两两比较结果显示,除对照组与肝功能A组之间的差异无统计学意义外,其余各组间的差异均具有统计学意义(F=31.44,P=0.00)。结论能谱CT扫描获得的肝动脉碘分数,与肝硬化门静脉高压患者的不同肝功能分级相关。

Objective To investigate the change modality of arterial iodine fraction obtained by dual energy spectral CT in cirrhotic patients of different Child - Pugh grade. Methods Ninety cirrhotic patients with portal hypertension were selected retrospectively into our study group, 31 cases were in Child- Pugh grade A, 40 in grade B, and 19 in grade C. The control group consisted of 18 cases with normal liver functionality. All cases underwent three-phase, dual-energy spectral CT scans on HDCT. The material decomposition images with water and iodine as basic material pairs were reconstructed using the HDCT spectral software package. The iodine concentrations for hepatic parenchyma in the arterial and portal vein phases were measured using the iodine-based material decomposition images. The arterial iodine fraction was obtained by dividing the iodine concentration in the arterial phase to that in the portal vein phase. AIF values from the study and control groups were compared using the analysis of variance and with the statistical significance of P 〈 0. 05. Results The AIF was 0.24 ±0. 03 in control group. In the study group, these values were 0. 29 ±0. 09 in Child -Pugh grade A, 0. 37 ±0. 10 in grade B and 0. 48 ±0. 12 in grade C groups. The difference of AIF between the study and control groups was found statistically significant （ P 〈 0. 05 ）. Conclusion The arterial iodine fraction, obtained by dual energy spectral CT, has correlation with the Child - Pugh grade in cirrhotic patients.