| 贺文,贾继东,何青.CT灌注成像对门脉高压分流术后肝血流灌注改变的评价[J].中国医学影像技术,2006,22(1):92~94 |
| CT灌注成像对门脉高压分流术后肝血流灌注改变的评价 |
| Hepatic perfusion changes after portosystemic shunt in cirrhosis patients with portal hypertension evaluated by CT perfusion imaging |
| 投稿时间：2005-08-03 修订日期：2005-11-08 |
| DOI： |
| 中文关键词: 门静脉高压 肝脏 灌注 体层摄影术,X线计算机 |
| 英文关键词:Portal hypertension Liver Perfusion Tomography, X-ray computed |
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| 中文摘要: |
| 目的应用多层螺旋CT观察肝硬变门脉高压患者门腔静脉分流后肝脏血流灌注的改变。方法 肝硬变门静脉高压合并上消化道出血患者15例。肝功能Child 分级A 级13 例、B 级2 例。在分流术的前后两周之内各进行一次CT血流灌注扫描。测量每一例患者的肝血流量(HBF)、肝血容量( HBV)、平均通过时间(MTT)、毛细血管通透性(PS) 和肝动脉灌注指数( HPI) 。所测参数与术中测量的分流前后门静脉压力作对照观察。结果 门腔静脉分流前/后的各灌注参数为: HBF120.0/110.1ml/(min·100ml)(P>0.05)、HBV17.9/20.9ml/100ml(P>0.05)、MTT13.6/14.2s(P>0.05)、PS 35. 8/ 37. 5 ml/ (min ·100 ml)(P>0.05)、HPI0.21/0.42(P<0.01)。门腔静脉分流前/ 后的门静脉压力为41. 7/ 28. 1cm 水柱P<0. 001)。结论肝脏CT 灌注成像显示肝硬变门脉高压患者的肝血流量下降,肝动脉指数在分流术后明显增高,提示门静脉灌注量降低。CT 血流灌注扫描助于了解肝硬变门脉高压的血流动力学改变。 |
| 英文摘要: |
| Objective To evaluate the hepatic perfusion changes af ter portosystemic shunt in cirrhosis patient s with portal hypertension by means of CT perfusion imaging. Methods Fifteen cirrhosis patient s with history of upper gast rointestinalbleeding were included in this study , 13 cases with Child A liver reserve , and 2 cases with Chlid B. All patient s underwentCT hepatic perfusion within 2 weeks before and af ter portosystemic shunt operation respectively. The perfusion parametersincluded hepatic blood flow(HBF), hepatic blood volume(HBV) , mean t ransit time (MTT), permeability surface (PS) and hepatic perfusion index(HPI). The result s of parameters measured were correlated with the portal vein pressure meas-ured before and af ter portal-systemic shunt during the operation. Results The hepatic perfusion parameters before/ af ter portal-systemic shunt were : HBF : 120.0/110.1ml/(min·100ml)(P>0.05),HBV:17.9/20.9ml/100ml(P>0.05),MTT:13.6/14.2s(P>0.05),PS:35.8/37.5 ml/(min·100ml)(P>0.05)and HPI:0.21/0.42 (P<0.01) . The portalvenous pressure before and af ter shunt were 41.7/ 28.1cm H2O (P<0.001) , respectively.Conclusion CT perfusion ima-ging showed that HBF decreased in cirrhosis patient s and HPI increased significantly af ter portosystemic shunt , which indi-cated a decrease of portal vein perfusion. CT perfusion scan is useful to access the hemodynamic changes in cirrhosis patient swith portal hypertension. |
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