采用双能量CT碘定量法研究肝硬化患者脾脏血流动力学变化

Quantitative Study of Hemodynamics of Spleen on Cirrhosis Patients by Dual-energy CT

目的应用双能量CT碘定量的方法,探讨肝硬化患者脾脏血流动力学改变。方法选择37例经临床确诊肝硬化患者及21例健康者(正常对照组),采用双能量CT行上腹部扫描,平扫为常规扫描,动脉期、门静脉期、延迟期行能谱成像(GSI)模式扫描,将数据传输至ADW4.5工作站并应用能谱分析软件进行后处理,在物质分离碘基图上测量碘浓度。在脾脏随机取直径约为20 mm的ROI,所得3个ROI的碘基值均值为脾脏增强扫描动脉期碘基值Ia及门静脉期碘基值Iv,并计算出脾动脉碘分数(AIF=Ia/Iv)。对正常对照组及肝硬化组统计学参数进行单因素分析,组间均数两两比较,P<0.05认为差异具有统计学意义。结果肝硬化组与正常对照组动脉期碘基值Ia(F=9.387,P<0.01)、脾动脉碘分数AIF(F=11.830,P<0.01)组间均数差异均存在统计学意义,且肝硬化门脉高压组Ia及AIF均明显高于正常对照组(102.32±15.75)vs(90.41±12.85),(0.90±0.15)vs.(0.77±0.13)mg I/ml);两组间静脉期碘基值Iv差异无统计学意义。结论肝硬化与正常对照两组病例间,脾脏的血流动力学存在明显差异,表现为肝硬化组脾动脉血流量高于正常对照组,双能CT的碘定量功能可用于评价肝硬化患者脾动脉的血流动力学改变。

Objective Using iodimetric analysis of dual-energy. CT （DECT）, to investigate the hemodynamics of spleen on cirrhosis patients. Methods A total of 37 cases of liver cirrhosis （study group） and 21 cases without liver disease （normal control group） were selected in this study. All cases were underwent upper abdomen scanning, plain scanning was underwent standard model, arterial phase, portal venous phase and delayed phase enhancement were underwent Gemstone Spectral Imaging（GSI） scanning by DECT scanner（American （;E Discovery CT 750 HD） with the same scanning parameters and contrast media contain iodine. The original data was transferred to work station ADW4.5 and post-processing by GSI software. Iodine concentration measurement was underwent on material decomposition of iodine base figure. A total of 3 region of interest （RO1） with diameter of 20 mm were selected in spleen, and the mean iodine concentration was calculate by the three ROls. So that iodine concentration of arterial phase （la） and portal venous phase （Iv） can be measured during the corresponding enhancement stage. The arterial iodine fraction （AIF=Ia/Iv） could be calculated. ALL parameters from study group and control group were compared by single factor analysis, and the differences of these measures were detected by ANOVA test.Reesults Both of the la and AIF had statistical significance between the liver cirrhosis group and control group with F=9.387, P〈0.01 and F=11.830, P〈0.01. la and AIF of liver cirrhosis group were higher than control group （102.32± 15.75）vs. （90.41 ± 12.85）, （0.9（1± 0.15）vs. （0.77 ±0.13）mg I/ml. There was no statistically significant difference between the two group on portal venous phase （P〉0.05）. Conclusion The hemodynamics of spleen was obvious different between the liver cirrhosis group and control group. Iodine quantitative function ofdual-energy CT can be used for evaluation of spleen henlodynamics on cirrhosis patients.