双能量CT碘图评估肝硬化血流灌注的可行性分析

Feasibility Analysis of Dual Energy CT Iodine Maps in Assessing Blood Perfusion of Cirrhosis

目的探讨第二代双源CT双能量成像碘图定量法评价肝硬化患者肝脏血流灌注变化的可行性。方法根据肝功能ChildPugh分级标准,收集正常人群及肝硬化患者肝脏双能量CT增强扫描图像及临床资料各30例,记录肝硬化患者肝脏各段动脉期(Ia)、静脉期碘值(Ip)、动静脉期CT值,计算肝动脉碘分数(AIF=Ia/Ip)及门静脉碘浓度差(PVIC=IP-Ia)。结果肝硬化组与正常组肝左右叶间分别比较,Ia、Ip、AIF、PVIC值均无统计学意义(P>0.05)。正常组与肝硬化组间比较各碘值参数,均有统计学意义(P<0.05)。正常组与肝硬化组动脉期CT值组间比较无统计学意义(P>0.05),静脉期CT值两组间比较有统计学意义(P<0.05)。结论第二代双源CT(DECT)碘图成像可反映肝硬化患者肝灌注的变化,为肝硬化患者定量评估提供一种新的方法。

Objective To evaluate the feasibility of quantitative method for second-generation dual-source dual-energy CT(DECT)iodine maps in assessing changes in hepatic perfusion in patients with liver cirrhosis.Methods According to the Child-Pugh grading for liver functionality,30volunteers with normal liver functionality as well as30patients with liver cirrhosis were enrolled in this study,respectively.The hepatic arterial phase(Ia),intravenous iodine value(Ip)(AIF=Ia/Ip)and the difference of iodine concentration in portal vein(PVIC=IP-Ia)were measured and compared between the two groups.Results There was no significant difference in Ia,Ip,AIF and PVIC between liver cirrhosis group and normal group as well as right lobe(P>0.05).Statistical significant difference of parameters in odine maps were found between the two groups(P<0.05).There was no significant difference in CT values between the group with normal liver functionality and the group with liver cirrhotic in arterial phase(P>0.05),but significant difference was found in CT values in venous phase between the two groups(P<0.05).Conclusion The second-generation DECT iodine images can reflect the changes of liver perfusion in patients with liver cirrhosis and further provide a new method for quantitative assessment of patients with liver cirrhosis.