常规肝灌注法与JOG技术在肝脏MSCT灌注中的对比研究

Comparison study of the JOG technique and the conventional hepatic CT perfusion method

目的通过与常规灌注法相比较,评价JOG技术在肝脏MSCT灌注中的应用价值。方法收集临床拟排除肝脏隐匿性病变而行肝脏MSCT灌注扫描患者,共43例,所有患者最终随访证实肝功能正常,且未发现异常病变。43例患者根据灌注方法不同,随机分成A、B两组,A组22例,采用常规灌注方法,B组21例,采用JOG技术。两组患者的注射及扫描参数相同。扫描结束后,利用灌注软件测量肝门层面的肝脏灌注参数值,并利用非配对样本-t检验,统计两组各灌注参数值间差异无统计学意义,并统计两组患者的射线剂量。结果A、B两组患者的HAP、HPP、TLP、HPI分别为（13.06±5.86）mL/（min·mL）、（12.27±5.60）mL/（min·mL）,（81.96±46.34）mL/（min·mL）、（68.65±37.12）mL/（min·mL）,（95.09±48.28）mL/（min·mL）、（80.83±38.55）mL/（min·mL）,16.14±8.76、17.46±8.98,经非配对样本t检验,两组间差异不具有统计学意义。有效剂量A组10.55-11.72 mSv,平均11.23 mSv;B组6.48~11.88 mSv,平均9.12 mSv,差异无统计学意义。结论 JOG技术同常规灌注方法相比,灌注值差异不具有统计学意义,可以用于全肝灌注以评价全肝或节段性肝脏功能储备,同时肝脏较大病灶（最大径〉5.0 cm）也可以选择性应用。

[Objective] To evaluate the application value of JOG technique in the hepatic MSCT perfusion by comparing with conventional MSCT perfusion method. [Methods] 43 patients suspected of latent hepatic disease underwent MSCT perfusion prospectively, and were proven with none hepatic disease. 43 patients were randomly assigned into A or B group according to the perfusion method selected. And, 22 patients were assigned into group A with the conventional perfusion method, and the other 21 patients were enrolled in group B with JOG technique. The injection and scan parameters were the same between the two groups. After the perfusion scan, the hepatic perfusion parameters and color maps were measured and produced with the function CT software, and the non-paired-t test were utilized to analyze the statistical difference of the perfusion parameters between this two groups. And the effective doses of group A and B were also counted. [Results] The HAP, HPP, TLP, HPI of group A and B were： 13.06± 5.86 mL·min·mL, 12.27 ± 5.60 mL·min· mL; 81.96 ± 46.34 mL·min·mL, 68.65 ± 37.12 mL·min·mL; 95.09 ± 48.28 mL·min·mL, 80.83 ± 38.55 mL·min· mL and 16.14 ± 8.76, 17.46 ± 8.98 respectively, and there was no statistical significance between groups. And the effective dose of group A ranged from 10.55 to 11.72 rosy, averaged 11.23 mSv, and that of group B ranged from 6.48 to 11.88 mSv, with an average of 9.12mSv. [Conclusion] The JOG technique, with no statistical significance of perfusion parameters with conventional CT perfusion method, could be utilized to evaluate the whole or partial hepatic functional reserve, and it could also be selected as the perfusion method of the mass with maximum diameter larger than 5 em.