肝硬化与正常肝脏双重血流量定量对比研究

Quantitative Contrast of Dual-perfusion Characteristic between Liver Cirrhosis and Healthy Liver

目的应用双能CT的碘定量功能,研究肝硬化与正常肝脏双重血供的差异。方法针对临床确诊的34例肝硬化组病例进行双能CT增强扫描,随机选择上腹部双能CT增强扫描正常肝脏27例作为对照组,将两组病例图像传输至工作站,应用能谱分析软件获得肝脏增强扫描动脉期、门静脉期、延迟期各叶兴趣区的碘基值,并计算出肝动脉碘分数与门静脉碘含量,再用SPSS13.0软件对各项参数进行独立样本t检验。结果动脉期肝硬化组和正常肝组之间,各叶碘基值总和相近,差异无统计学意义(P>0.05),但肝硬化组的左外叶动脉期碘基值明显高于正常组,差异具有统计学意义(P=0.033)。门静脉期肝硬化组和正常组之间,各叶碘基值总和差异有统计学意义(P=0.039);肝硬化组门静脉期左内叶和右叶的碘基值明显低于正常组,差异具有统计学意义(P=0.021,0.001)。肝硬化组延迟期左外叶和尾状叶的碘基值明显高于正常组,差异有统计学意义(P=0.021,0.031)。肝硬化组左外叶、左内叶及右叶肝动脉碘分数即AIF与正常组比较,差异均有统计学意义(P<0.05);肝硬化组左外叶、左内叶及右叶的门脉期与动脉期碘含量之差P V I C与正常组比较,差异均有统计学意义(P<0.05);肝硬化组左外叶、左内叶及右叶AIF均高于正常组,门静脉供血量低于正常组。结论肝硬化与正常肝脏两组病例间,在门静脉期和延肝脏各叶的血供存在明显差异,双能CT的碘定量功能可用于评价肝硬化的血流动力学改变。

Objective To explore the differences of dual-perfusion in left lateral lobe, left medial lobe, fight lobe and caudate lobe between healthy liver and liver cirrhosis by using the iodimetric function of dual-energy CT. Method34 cases with liver cirrhosis and 27 cases without hepatic diseases underwent contrast-enhanced upper abdomen dual-energy CT scanning in GSI mode. The raw data were transferred to the workstation. Regions of interest （ROl） were selected, and the iodine concentration in arterial phase, portal venous phase and delay phase in different hepatic lobes, the arterial iodine fraction（ AIF ）and the portal venous iodine concentration （PVIC） in two groups were calculated. The differences of these param- eters were detected by independent sample t test. ResultThe sum of iodine concentration in all the lobes during arterial phase in the study group had no statistical difference with the control groulK P〉0.05 ~ The iodine concentration in the left lateral lobe during arterial phase in the study group was significantly higher than that in the control group （ P=0.033 ）. The sum of iodine concentration in all the lobes during pomal venous phase in the study ~,n＇oup was sif.~nificantlv lower than that in the control group（ P=0.039 ）; The iodine concentration in the left medial lobe and fight lobe during portal venous phase in the study gToup was sigIfificantlv lower than that in the control group（ P=0.021,0.001 ）. The iodine concentration in the left lateral lobe and caudate lobe during delay phase in the study group was significantlv higher than that in the control group （ P=0.021, 0.031 ）. The arterial iodine fraction ot left lateral lobe, left medial lobe and right lobe in the study group was significantly higher than that in the control group, and portal venous iodine concentration in the left lateral lobe, lett medial lobe and right lobe in the study group was significantly lower than that in the control group. Conclusion Dual-energy CT can be used to study the dual-perfusion condition of liver cirrhosis. The blood-supply quantity of left lateral lobe, left medial lobe, right lobe and caudate lobe in the liver cirrhosis is significantly different than that in the healthy liver.