基于平扫的肝个体化时间点增强扫描方式的临床应用

Clinical application of individualized time point enhanced liver scanning based on plain scan

目的对比肝胆疾病患者基于肝平扫情况制定个体化时间点扫描与固定时间点扫描的差异及其临床应用。方法选择2018年2月至2019年10月本院收治的进行肝脏检查的肝胆疾病患者399例,根据肝平扫图像划分5个影像级别,进而对5个影像级别归类分正常、轻度、中度及重度4个肝硬化级别分层研究。采用队列研究方式,分组行个体化时间点扫描(实验组)或固定时间点扫描(对照组),对比分析各期所得的肝实质、门静脉、肝静脉等CT值及相互差值共11项数据。结果实验组和对照组仅在轻度肝硬化患者中,门静脉期门静脉CT值、实质期门静脉CT值、实质期肝实质平均CT值、门静脉期肝静脉与肝实质平均值差值绝对值差异有统计学意义(P<0.05),余7项数据差异无统计学意义。结论个体化时间点扫描对正常、中度及重度肝硬化患者而言并无明显优势,对轻度肝硬化患者的肝实质强化质量有改善,具有一定的临床推广价值。

Objective To compare the efficacy of individualized time point scanning mode based on the liver plain scan versus fixed time point scanning in patients with hepatobiliary diseases.Methods A total of 399 patients with hepatobiliary diseases who underwent liver examination from February 2018 to October 2019 were selected.According to the liver plain scan images,five image levels were divided into four grades:normal,mild,moderate and severe cirrhosis.In the cohort study,the patients were divided into two groups:experimental group(individualized time point scanning)and control group(fixed time point scanning).Results The portal vein CT value in the portal phase,the CT value in the parenchymal phase,the average CT value in the parenchyma phase,and the absolute value of the difference between the average value of the hepatic vein and the liver parenchyma in the portal phase in patients with mild liver cirrhosis were statistically different between control group and experimental group(P<0.05),while the other 7 items showed no statistical significance.Conclusion The individualized time point scanning has no obvious advantages in patients with normal,moderate and severe liver cirrhosis.It can improve the quality of liver parenchyma enhancement in patients with mild liver cirrhosis,and has certain clinical value.