256层CT全肝灌注成像对肝纤维化血流动力学的评价

The evaluation of hepatic fibrosis blood-dynamics with 256 planar CT full perfusion

目的：应用256层CT灌注成像观察肝纤维化血流动力学指标的改变，提高诊断的准确性。方法：正常对照组29例，肝纤维化组s1～s2期20例、s3～s4期15例行螺旋扫描全肝脏灌注，于灌注图上计算肝动脉灌注量（hepaticarterialper—fusion，HAP）、门静脉灌注量（hepaticportalperfusion，HPP）、总肝灌注量（hepatictotalperfusion，HTP）和肝动脉灌注指数（hepeticperfusionindex，HPI）值，对各组数据进行单因素方差分析并两两检验。结果：肝纤维化各期均有相应的病理改变。HAP在s1～S2期为（13．68±4．02）ml·min-1·100ml-1，与对照组之间差异无统计学意义；在s3～s4期为（25．10±7．36）ml·min-1·100ml，明显增高，与正常组和s1～S2组差异具有统计学意义；HPI在s1～s2期为（22．11±4．88）％，S3～S4期为（32．07±7．35）％，与正常组、病变组之间比较逐步增高，差异均具有统计学意义。HPP和HTP数据缺乏稳定性。结论：256层CT全肝灌注，HAP和HPI能反映病变的血流动力学变化，为诊断肝纤维化提供稳定和有价值的指标；而HPP、HTP指标不稳定，需要进一步探讨。

Objective： To apply 256 planar CT perfusion for evaluating blood-dynamics indexes of hepatic fibrosis and promoting correctness of diagnosis. Methods：The spiral CT full hepatic perfusion were performect in 29 healthy persons, patients with he- patic fibrosis including 20 cases of S1-S2,15 cases of S3-S4. HAP, HPP, HTP and HPI were calculated from false-colour im- aging. The data were analyzed by statistics of One-Way ANOVA. Results：Different stages of hepatic fibrosis were approved by corresponding pathological changes. HAP,the value of S1-S2 was （13.68±4.02）ml. min -1 . 100 ml -1 that had no statistical difference from normal persons. In S3-S4,the value was （25.10±7.36）ml .min-1 . 100 ml-1 that had statistical differences compared with normal persons and S1-S2. HPI, the value of S1-S2 was （22.11±4.88）% and the value of S3-S4 was （32.07± 7.35）% that gradually increased according to the stages and all the data had statistical differences. HPP and HTP, the data manifested non-stability. Conclusion：In 256 planar CT full hepatic perfusion, HAP and HPI are able to express blood-dy- namics changing of the diseases and provide stable and valuable indexes for diagnosing hepatic fibrosis. But the values of HPP, HTP are not stable. It is necessary to further evaluate.