摘要
目的应用双能CT碘图观察乙肝肝硬化患者肝脏动脉期、门静脉期、延迟期肝实质碘浓度参数变化,探讨其与肝脏储备功能的关系。方法乙肝肝硬化患者53例为肝硬化组,同期肝脏正常者22例为对照组,2组均应用双源CT双能序列行肝脏动脉期、门静脉期、延迟期增强扫描,应用软件分析动脉期肝实质碘浓度(iodine concentration in arterial phase,Ia)、门静脉期肝实质碘浓度(iodine concentration in portal vein phase,Ip)、延迟期肝实质碘浓度(iodine concentration in delayed phase,Id)、肝动脉碘分数(arterial iodine fraction,AIF)、门静脉碘浓度(portal venous iodine concentration,PVIC)。根据Child-Pugh分级将53例肝硬化患者分为A级组(Child-Pugh评分5~6分)、B级组(Child-Pugh评分7~9分)、C级组(Child-Pugh评分≥10分),比较3组Ia、Ip、Id、AIF、PVIC。结果肝硬化组Ia[(0.75±0.21)mgI/mL]、AIF(0.41±0.13)均高于对照组[(0.50±0.12)mgI/mL、0.24±0.06](t=6.300,P<0.001;t=7.595,P<0.001),Ip[(1.85±0.26)mgI/mL]、PVIC[(1.11±0.34)mgI/mL]均低于对照组[(2.14±0.32)、(1.64±0.32)mgI/mL](t=4.035,P<0.001;t=6.225,P<0.001),Id[(1.65±0.22)mgI/mL]与对照组[(1.70±0.36)mgI/mL]比较差异无统计学意义(t=0.778,P=0.439)。A级组Ia[(0.65±0.15)mgI/mL]、AIF(0.35±0.08)均低于B级组[(0.82±0.17)mgI/mL、0.45±0.11]、C级组[(1.01±0.27)mgI/mL、0.60±0.12](P<0.05),B级组均低于C级组(P<0.05);A级组Ip[(1.90±0.25)mgI/mL]、PVIC[(1.25±0.28)mgI/mL]均高于B级组[(1.82±0.29)、(1.01±0.31)mgI/mL]、C级组[(1.67±0.16)、(0.65±0.19)mgI/mL](P<0.05),B级组均高于C级组(P<0.05);3组Id比较差异均无统计学意义(P>0.05)。结论乙肝肝硬化患者肝脏双能CT碘图表现为Ia、AIF升高,Ip、PVIC降低,碘浓度参数可实时定量反映乙肝肝硬化患者肝脏血流动力学变化及肝脏储备功能。
Objective To observe the changes of iodine concentration parameters in liver parenchyma of patients with hepatitis B cirrhosis in arterial phase,portal venous phase and delayed phase with dual-energy CT,and to investigate their relationships with liver reserve function.Methods Dual-energy CT dual energy sequence was performed for enhanced scanning in arterial phase,portal venous phase and delayed phase of the liver in 53patients with hepatitis B cirrhosis(cirrhosis group)and 22healthy volunteers(control group).The software was used to analyze the iodine concentrations in arterial phase(Ia),portal venous phase(Ip)and delayed phase(Id),hepatic arterial iodine fraction(AIF),and portal venous iodine concentration(PVIC).According to Child-Pugh scoring,53patients were divided into grade A group(Child-Pugh score:5-6),grade B group(Child-Pugh score:7-9)and grade C group(Child-Pugh score:≥10),and the values of Ia,Ip,Id,AIF and PVIC were compared among three groups.Results The values of Ia and AIF were higher in cirrhosis group[(0.75±0.21)mgI/mL,0.41±0.13]than those in control group[(0.50±0.12)mgI/mL,0.24±0.06](t=6.300,P<0.001;t=7.595,P<0.001),Ip and PVIC were lower in cirrhosis group[(1.85±0.26),(1.11±0.34)mgI/mL]than those in control group[(2.14±0.32),(1.64±0.32)mgI/mL](t=4.035,P<0.001;t=6.225,P<0.001),and there was no significant difference in Id value between cirrhosis group[(1.65±0.22)mgI/mL]and control group[(1.76±0.36)mgI/mL](t=0.778,P=0.439).Ia and AIF were lower in grade A group[(0.65±0.15)mgI/mL,0.35±0.08]than those in grade B group[(0.82±0.17)mgI/mL,0.45±0.11]and grade C group[(1.01±0.27)mgI/mL,0.60±0.12](P<0.05),and were lower in grade B group than those in grade C group(P<0.05).Ip and PVIC were higher in grade A group[(1.90±0.25),(1.25±0.28)mgI/mL]than those in grade B group[(1.82±0.29),(1.01±0.31)mgI/mL]and grade C group[(1.67±0.16),(0.65±0.19)mgI/mL](P<0.05),and higher in grade B group than those in grade C group(P<0.05).There was no significant differences in Id value among three gro
作者
魏海云
周舟
WEI Hai-yun;ZHOU Zhou(Department of Radiology,the First Affiliated Hospital of Henan University of Chinese Medicine,Zhengzhou,Henan 450000,China)
出处
《中华实用诊断与治疗杂志》
2023年第1期93-96,共4页
Journal of Chinese Practical Diagnosis and Therapy
基金
河南省中医药科学研究专项课题(2018ZY2088)。
关键词
乙肝
肝硬化
双能CT
碘图
肝脏储备功能
hepatitis B
cirrhosis
dual-energy CT
iodine map
liver reserve function
