CT灌注成像在诊断肝纤维化、肝硬化中的应用

CT perfusion imaging in the diagnosis of liver fibrosis and cirrhosis of the liver

目的探讨CT灌注成像血流动力学参数在肝纤维化、肝硬化中的变化趋势。方法将79例研究对象分为四组：正常对照组、s1-S2组、s3-s4组、肝硬化组，比较四组年龄、性别基线资料，比较灌注参数（HAP、PVP、TLP、HPI、TTP）是否有差异。结果四组基线资料年龄、性别均衡可比；HAP随着纤维化程度加重，变化趋势不明显，但肝硬化组明显高于其他三组；PVP随着纤维化程度加重，其值逐渐降低；TLP在纤维化组明显低于对照组，且以肝硬化组最低；HPI、TTP随着纤维化程度加重，其值逐渐升高。结论HAP、TLP可以为临床诊断晚期肝硬化提供帮助，但对纤维化程度的定量评判不可靠；PVP、HPI、TTP可以为临床无创诊断肝纤维化、肝硬化提供一定参考价值；CT灌注成像对诊断肝纤维化、肝硬化有一定的指导作用。

Objective To explore the changing trends of the liver hemodynamic parameters in diagnosis of liver fibrosis and cirrhosis of the liver by CT perfusion imaging. Methods 79 cases of the object were divided into four groups： normal control group, S1-S2 group, S3-S4 group, the liver cirrhosis group. The difference between age, gender, perfusion parameters （HAP, PVP, TLP, HPI, TIT） were Compared. Results The baseline data of age and gender in the four groups were balanced comparable;HAP was aggravated with fibrosis degree,and the change trend was not obvious,but liver cirrhosis group was significantly higher than the other three groups.PVP was gradually reduced with the deepening fibrosis degree. Fibrosis group was significantly lower than the control group in TLP, and the lowest value was in cirrhosis group. The value of HPI and TTP was increased with the fibrosis degree aggravating. Conclusion The HAP and TLP can provide hint for late clinical diagnosis of cirrhosis of the liver, but it is not reliable for evaluating the degree of fibrosis of quantitative.The PVP, HPI and TIP can provide certain reference value to clinical noninvasive diagnosis of liver fibrosis and cirrhosis of the liver.CT perfusion imaging in diagnosis of liver fibrosis and cirrhosis of the liver has a certain guiding role.