多层螺旋CT灌注成像在门脉高压性胃肠病的应用价值

The value of multiple-slice spiral CT perfusion imaging in the study of portal hypertensive gastroenteropathy

目的评价CT灌注技术对门脉高压性胃肠病(portal hypertensive gastroenteropathy,PHGE)患者胃肠道血流动力学定量研究的价值。方法对20例正常对照者及26例PHGE患者进行十二指肠降段CT灌注扫描,记录肠壁血流量(blood flow,BF)、对比剂平均通过时间(mean transit time,MTT)、血管渗透性(permeability,PMB)达峰时间(Time To Peak,TTP)和血容量(blood volume,BV),并对两组参数进行对比分析。结果正常对照组与PHGE组的BF值分别为(173.02±85.14)ml/100g tissue/min和(82.52±52.37)ml/100g tissue/min(P=0.003);MTT分别为(10.78±2.65)s和(16.32±3.74)s(P=0.003);PMB分别为(36.79±22.14)ml/100g tissue/min和(22.36±11.02)ml/100g tissue/min(P=0.005)。正常对照组与PHGE组间达峰时间(time to peak,TTP)、血容量(blood volume,BV)差异无统计学意义(P=0.485;BV值:对照组(21.42±11.25)ml/100g tissue,PHGE组(16.84±9.46)ml/100g tissue,P=0.327)。结论 PHGE患者胃肠道CT灌注显示BF、PMB减低,MTT明显延长,可对PHGE患者胃肠道微循环及血流动力学的改变早期发现并做出定量评估。

Objective To investigate the value of CT perfusion technique in evaluating hemodynamics changes of portal vein pressure of gastrointestinal diseases （PHGE） .Methods Twenty healthy volunteers （control group） and twenty-six patients with PHGE were examined using CT perfusion .The blood flow （BF） ,mean transit time （MTT） ,permeability （PMB） ,time to peak （TTP） and blood volume （BV） of descending duodenum were recorded .These parameters of perfu-sion of two groups were analyzed using SPSS 13 .0.Results BF value of control group and PHGE were （173 .02 ± 85 .14） ml/100g tissue /min and （82 .52 ± 52 .37） ml/100g tissue/min （ P=0.003） .MTT of control group and PHGE group were（10.78±2 .65）s and （16.32 ± 3.74） s .（ P=0.003）;PMB were （36.79±22.14） ml/100g tissue/min and （22.36±11.02） ml/100g tissue/min .（ P=0.005） .No differences between control group and PHGE were found in TTP （P=0.485） and BV （P=0.327） .Conclusion Deceased BF ,PMB and prolonged MTT of gastrointestinal tract of PHGE suggested that CT perfusion can evaluate the hemodynamics quantitatively in PHGE .