摘要
目的:通过研究肝硬化患者双能量CT碘定量参数肝动脉供血比重碘分数(AIF)及门静脉血流碘含量(PVIC)改变,探讨AIF及PVIC反映肝硬化患者血流灌注分布情况及肝功能的临床价值。方法:选择55例经临床确诊肝硬化患者(研究组)及26例健康者(对照组),进行上腹部CT扫描,增强动脉期、门静脉期、延迟期为能谱成像(GSI)模式扫描,应用能谱分析软件进行后处理。分别在动脉期、静脉期物质分离碘基图上于肝脏左外叶、左内叶及右叶各取1个直径10mm的ROI,测得ROI的碘浓度均值为增强扫描动脉期碘浓度(Ia)及门静脉期碘浓度(Ip),计算AIF、PVIC。对肝硬化组及正常对照组AIF、PVIC进行单因素分析,组间均数两两比较;肝硬化组AIF、PVIC分别与肝功能CTP分级评分进行Spearman相关性分析,P<0.05认为差异具有统计学意义。结果:肝硬化组Child-Pugh B级、C级AIF与正常对照组均数差异具有统计学意义(F=68.650,P<0.01),且Child-Pugh B级、C级AIF均高于正常对照组,分别为(31.70±5.07)%,(47.74±5.75)%vs(21.06±4.29)%,AIF与肝硬化CTP分级评分呈正相关(r1=0.780,r2=0.848,P<0.01)。肝硬化组Child-Pugh A、B、C级PVIC与正常对照组均数差异均具有统计学意义(F=14.949,P<0.01),且均低于正常对照组,分别为(1.72±0.51)、(1.37±0.38)、(0.94±0.27)和(2.08±0.54)mg/mL;肝硬化组Child-Pugh A、B、C级PVIC呈逐级递减,差异具有统计学意义(P<0.05),与肝硬化CTP分级评分呈负相关(r1=-0.608,r2=-0.548,P<0.01)。结论:双能量CT参数AIF及PVIC的改变反映了肝硬化后门静脉对肝脏的血流灌注相对减少,且随肝硬化程度加重而呈逐级递减,Child-Pugh B级、C级出现肝动脉血流灌注增多;AIF及PVIC与肝硬化的临床分级相关,可作为评估肝功能储备状况的参考依据。
Objective： To assess the clinical value of dual-energy CT （DECT） parameters including arterial iodine fraction （AIF） and portal venous blood flow iodine content （PVIC） in the evaluation of hemodynamics and liver function in patients with cirrhosis. Methods：A total of 55 cases with liver cirrhosis （study group） and 26 cases without hepatic disease （control group） were enrolled in the study. All cases underwent upper abdomen CT scan. The enhancement scan protocol of gemstone spectral imaging （GSI） including arterial phase, portal venous phase and delayed phase were performed with DECT scanner （GE Discovery CT 750 HD）. Iodine concentration was measured on material decomposition of iodine base figure. Region of interest （ROI） was selected in left lateral lobe,left medial lobe and right lobe of liver respectively and mean liver parenchyma iodine concentration of arterial phase （In） and portal venous phase （Ip） were calculated. The arterial iodine fraction （AIF=Ia/Ip） and the portal venous blood flow iodine content （PVIC≈Ip-In） were calculated. AIF and PVIC were compared by single factor analysis,and the difference between groups was analyzed in pairs. The correlation among AIF,PVIC and CTP grade, score were evaluated by Spearman＇s correlation analysis. Results： laver cirrhosis group （Child-Pugh B,C） and control group were statistically different in AIF （F = 68. 650, P〈0.01）. AIF of Child-Pugh B, C were higher than that of control group [（31. 70±5. 07）%,（47.74±5.75） % vs （21.06±4.29） %]. AIF was positively cor related with CTP grade in patients with liver cirrhosis （r1= 0. 780, r2 = 0. 848, P〈0. 01）. Liver cirrhosis group （Child-Pugh A,B,C） and control group were different in PVIC with statistically significance （F 14. 949,P〈0.01）. PVICs of Child-Pugh A,B,C were lower than that of control group [（1.72±0.51） ,（1.37±0.38）,（0.94±0.27） vs （2.08±0.54） mg/mL],and showed an declining trend with statistically
出处
《放射学实践》
北大核心
2017年第7期734-738,共5页
Radiologic Practice
基金
深圳市科技计划项目(JYCJ20150403091443313)
关键词
肝硬化
体层摄影术
X线计算机
肝功能
Liver cirrhosis
Tomography,X-ray computed
Liver function
