摘要
目的比较不同肝功能分级布加综合征（BCS）患者治疗前后肝脏标准化碘基值（NIC），探讨能谱CT评估BCS治疗效果的临床价值。方法收集郑州大学第一附属医院2015年12月至2017年3月41例经血管成像证实的BCS患者资料。所有患者均于治疗前后行CT能谱扫描，两者间隔时间1～3个月。测量并计算门静脉期肝脏Ⅰ～Ⅷ段碘基值（Ic）及NIC。记录患者临床肝功能指标。治疗前后肝脏NIC及肝功能相关指标的比较采用配对t检验；治疗前肝脏NIC与肝功能的关系采用Pearson相关性分析。结果分析显示凝血酶原时间（PT）及TBil水平与肝脏NIC呈负相关（P〈0．05），而白蛋白（Alb）则与肝脏NIC呈正相关（P〈0．05）。肝功能A级患者PT、Alb及TBil水平与肝脏NIC的相关性高于B级和C级患者（r=-0．749、0．658、-0．511）。治疗后总体肝脏Ⅰ～Ⅷ段NIC均大于治疗前，其中肝脏Ⅱ～Ⅷ段的差异有统计学意义（P〈0．05）。肝功能C级患者治疗后肝脏Ⅰ～Ⅷ段NIC升高较B级和A级明显，其中肝功能A级患者肝脏Ⅳ、Ⅴ、Ⅷ段，B级患者肝脏Ⅲ～Ⅷ段，C级患者肝脏Ⅱ～Ⅷ段治疗前后NIC差异有统计学意义（P〈0．05）。与治疗前比较，治疗后门缩短，Alb升高，TBil、ALT及AST下降。结论能谱CT的NIC有助于评估BCS患者的肝功能状态。
Objective TO investigate the use of spectral CT in assessing the treatment effect on he- patic function in patients with Budd-Chiari syndrome （BCS） before and after treatment. Methods From Dec. 2015 to Mar. 2017, 41 patients with BCS underwent Spectral CT before and after treatment （mean time interval from treatment 1 - 3 months） in the First Affiliated Hospital of Zhengzhou University. The Io- dine concentration （IC） measured on the hepatic section Ⅰ～Ⅷ in the portal venous phase were normalized to the aorta （NIC）. The clinical indicators of liver function were studied including Prothrombin time （ PT）, Albumin （ Alb ）, Total bilirubin （ TBil ） , Aspartate transaminase （ AST）, and Alanine transarminase （ALT）. The paired t test was used to compare NIC and the various indices of hepatic function before and af- ter treatment. The correlation before and after treatment between NIC and the different liver functions were analyzed by the Pearson correlation analysis. Results While both lYF and TBil were negatively correlated （ P 〈 O. 05 ）, Alb was positively correlated with hepatic NIC （ P 〈 0.05 ）. The correlation of PT, Alb and TBil in patients with Child-Pugh class A liver function were higher than those in classes B and C （ r = -0. 749, 0. 658, -0. 511 ）. The NIC in the hepatic section Ⅰ～Ⅷ after treatment were higher than those before treatment, with significant differences in hepatic section Ⅱ～Ⅷ. The differences between after and be- fore treatment in patients with Child-Pugh class C liver function were higher than those in classes A and B. The hepatic section Ⅳ、Ⅴ、Ⅷ of class A, the hepatic section Ⅲ～Ⅷ of class B, hepatic section Ⅱ～Ⅷ of classes C were statistically significant. Compared with patients before treatment, the indices of liver function in patients after treatment showed better results （ shorter PT, higher ALB, lower TBil, ALT and AST）. Conclusion Normalized iodine concentration from spectral CT was helpful in e
作者
苏蕾
梁盼
胡丽丽
吴艳
高剑波
Su Lei, Liang Pan, Hu Lili, Wu Yan, Gao Jianbo.(The Department of Radiology, the First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, Chin)
出处
《中华肝胆外科杂志》
CAS
CSCD
北大核心
2018年第3期158-161,共4页
Chinese Journal of Hepatobiliary Surgery
关键词
布加综合征
体层摄影术
能谱成像
血管成像
Budd-Chiari syndrome
X-ray computed tomography
Spectral imaging
Angiog- raphy
