五期CECT肝脏灌注成像在肝硬化评估中的应用价值

Evaluation of hepatic perfusion parameters in patients with cirrhosis by five-phase CECT

目的:探讨五期增强CT(contrast-enhanced CT,CECT)肝脏灌注成像在肝硬化评估中的应用价值,以期为临床提供指导。方法:选取2017年2月至2018年10月在某院治疗的肝硬化患者87例作为观察组(均行五期CECT扫描),其中,代偿期患者32例,失代偿期患者55例;乙肝肝硬化患者74例,酒精性肝硬化患者13例。选取同期疑似肝脏病变行五期CECT扫描结果正常者作为对照组(45例)。对比2组患者及观察组不同病情、不同类型肝硬化患者的肝动脉灌注指数(hepatic arteial perfusion index,HPI)、肝动脉灌注量(hepatic arteial perfusion,HAP)、门静脉灌注量(hepatic portal vein perfusion,HPP)、血流量(blood flow,BF)和血容量(blood volume,BV)。采用SPSS 19.0软件进行数据分析。结果:观察组HPI、HAP明显高于对照组(P<0.05),而HPP明显低于对照组(P<0.05),2组间BF和BV比较无显著性差异(P>0.05);观察组失代偿期患者HPI和HAP明显高于代偿期患者(P<0.05),而HPP明显低于代偿期患者(P<0.05),2组间BF和BV比较无显著差异(P>0.05);乙肝肝硬化和酒精性肝硬化患者的HPI、HAP、HPP、BF和BV比较无显著差异(P>0.05)。结论:五期CECT肝脏灌注成像在肝硬化评估中具有较好的应用价值。

Objective To explore the value of five-phase contrast-enhanced CT(CECT)in evaluating hepatic perfusion parameters in patients with liver cirrhosis,in order to provide guidance and basis for clinical practice.Methods Eighty-seven patients with cirrhosis examined with five-phase CECT and treated at some hospital from February 2017 to October 2018 were selected into an observation group,including 32 patients at compensatory stage and 55 patients at decompensation stage,and 74 patients with hepatitis B cirrhosis and 13 patients with alcoholic cirrhosis;45 ones with normal liver examination results by five-phase CECT were enrolled into a control group.Comparison was carried out on hepatic arterial perfusion index(HPI),hepatic arterial perfusion(HAP),hepatic portal vein perfusion(HPP),blood flow(BF)and blood volume(BV)for the patients in the two groups and the ones with different conditions or different types of cirrhosis in the observation group.SPSS 19.0 software was used for data analysis.Results The observation group had the values of HPI and HAP higher significantly than those in the control group(P<0.05),while that of HPP lower obviously(P>0.05);the patients at compensatory stage had the values of HPI and HAP higher statistically than those at decompensation stage(P<0.05),while that of HPP lower significantly(P>0.05);there were no significant differences between the values of BF and BV in the two groups(P>0.05);the patients with hepatitis B cirrhosis had no statistical differences with the ones with alcoholic cirrhosis in HPI,HAP,HPP,BF and BV values(P>0.05).Conclusion Five-phase CECT is of great value for evaluating liver perfusion in patients with liver cirrhosis.