肝硬化多层螺旋CT血流灌注参数与MELD评分的相关性研究

Research of Correlation Between Hepatic Perfusion Parameters with MSCT Scans and the Model for End-stage Liver Disease Scores in Patients with Liver Cirrhosis

目的采用16层螺旋CT对肝硬化患者行CT灌注扫描,研究肝硬化患者血流灌注参数变化与终末期肝病模型(MELD)评分的关系。方法 28例肝硬化患者,均行CT灌注扫描,按MELD评分进行分组,计算灌注参数,进行统计学分析,并对灌注参数与MELD评分之间的相关性进行分析。结果 BF由(110.3±28.5)mL·(min·100g)-1下降至(89.5±20.8)mL·(min·100g)-1,HAF由(0.16±0.67)升高至(0.31±0.13),HAP由(18.1±7.94)mL·(min·100g)-1升高至(28.5±14.6)mL·(min·100g)-1,PVP由(92.2±25.3)mL·(min·100g)-1下降至(62.5±1.97)mL·(min·100g)-1,P均<0.05。BV值(11.0±1.3)mL/100g下降至(10.8±0.69)mL/100g,但差异无统计学意义。PVP值与MELD评分呈负相关,r分别为-0.297、-0.128、-0.550;HAF值、HAP值与MELD评分呈正相关,r分别为0.710、0.550。结论多层螺旋CT灌注成像可以准确的反映肝脏血流情况,从而反映肝功能状况,而且与MELD评分高度相关,可以作为临床评价肝硬化程度的重要手段。

Objective To explore the correlation between perfusion parameters with MSCT scan and MELD scores in patients with cirrhosis and end-stage liver disease.Methods 28 patients with liver cirrhosis underwent CT perfusion scans and grouped according to MELD score.Perfusion parameters were calculated and the correlation between perfusion parameters and MELD score was analyzed.Results Compared patients with MELD ≤6 to patients with MELD 〉 6,BF decreased from （110.±28.5） mL · （min · 100g）-1 to （89.5 ± 20.8） mL · （min · 100g）-1,HAF increased from （0.16 ± 0.67） to （0.31 ±0.13）,HAP from （18.1 ±7.94） mL · （min · 100g）-1 increased to （28.5 ± 14.6） mL · （min · 100g）-1,PVP decreased from （92.2 ± 25.3） mL · （min · 100g）-1 to （62.5 ± 1.97） mL · （min ·100g）-1,all the above showed statistically significant （P ≤ 0.05）.BV values decreased from （11.0 ± 1.3）mL/100g to （10.8 ± 0.69） mL/100g,but not statistically significant.BF value,BV value and PVP values were significantly negatively correlated with MELD score and correlation coefficients were-0.297,-0.128,-0.550.HAF value,HAP value were significantly positively correlated with MELD score while correlation coefficients were 0.710,0.550.Conclusion CT perfusion imaging can accurately reflect the hepatic blood flow,and thereby reflect liver function,and highly correlated with MELD score.It can be an important means to evaluate the degree of cirrhosis in clinical application.