| 杨保智,郭顺林,郭吉刚,王刚,张安,徐凤.64层螺旋CT灌注成像对肝纤维化的临床应用研究[J].中国医学影像技术,2008,24(4):565~569 |
| 64层螺旋CT灌注成像对肝纤维化的临床应用研究 |
| Clinical study of 64-slice spiral CT perfusion imaging for hepatic fibrosis |
| 投稿时间：2007-12-10 修订日期：2008-03-15 |
| DOI： |
| 中文关键词: 肝炎,乙型,慢性 肝纤维化 磁共振血管造影术 体层摄影术,X线计算机 |
| 英文关键词:Hepatitis B, chronic Hepatic fibrosis Magnetic resonance angiography Tomography, X-ray computed |
| 基金项目:兰州大学医学科研基金资助项目(LZUYX200653)。 |
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| 中文摘要: |
| 目的 探讨64层螺旋CT灌注成像技术对慢性乙型肝炎肝纤维化诊断的应用价值。方法 分别对68例经病理诊断为慢性乙型肝炎肝纤维化患者和20例正常志愿者行64层螺旋CT肝脏灌注扫描,应用肝脏灌注分析软件获得不同病理阶段的肝脏灌注参数:肝动脉灌注量(ALP)、门脉灌注量(PVP)、肝脏灌注指数(HPI)、血流量(BF)、血容量(BV)和渗透性(P),与病理作对照并进行统计学分析。结果 计算所得时间-密度灌注曲线符合数据分析要求。正常对照组的ALP为(26.96±3.11) ml·100 ml-1·min-1,PVP为(102.84±5.56) ml·100 ml-1·min-1,HPI为(20.31±2.03)%,BF为(47.70±3.13) ml·100 ml-1·min-1,BV为(135.55±4.53) ml/L和 P为(68.08±1.05) 0.5 ml·100 ml-1·min-1。乙型肝炎肝纤维化组的ALP、PVP、HPI、BF、BV和P分别为:(28.73±4.09) ml·100 ml-1·min-1、(94.14±5.56) ml·100 ml-1·min-1、(22.42±2.07)%、(40.95±3.94) ml·100 ml-1·min-1、(123.80±7.21) ml/L和(68.59±1.39)0.5 ml·100 ml-1·min-1。统计结果显示肝纤维化组的PVP、BF、BV较对照组降低,差异有显著性(P＜0.05),且随肝纤维化程度加重呈逐渐降低趋势,S3、S4期分别与对照组、S1期比较有统计学差异,S2期与对照组比较有统计学差异;HPI较对照组升高(P＜0.05),且随肝纤维化程度加重逐渐增高,S3、S4期分别与对照组、S1期比较有统计学差异;ALP和P组间比较无统计学差异(P＞0.05)。结论 64层螺旋CT肝脏灌注成像能够反映乙型肝炎肝纤维化及早期肝硬化的血流灌注改变,灌注参数的变化与肝纤维化的严重程度相关,对临床的早期诊断、治疗和疗效观察有重要价值。 |
| 英文摘要: |
| Objective To investigate the value of CT perfusion imaging in diagnosis of hepatic fibrosis in patients with chronic hepatitis B. Methods Siemens 64-slice spiral CT perfusion scans of liver were performed in 88 individuals, including 20 volunteers without hepatic disorder and 68 patients with hepatic fibrosis proven by pathology. Arterial liver perfusion (ALP), portal venous perfusion (PVP), hepatic perfusion index (HPI), blood flow (BF), blood volume (BV) and permeability (P) in different pathologic stage were obtained with body perfusion software and compared with pathologic change, then the statistical analysis was performed. Results Calculated density-time curve of CT perfusion was satisfactory and all perfusion data could be obtained. The data of ALP, PVP, HPI, BF, BV and P in the control group were (26.96±3.11) ml·100 ml-1·min-1, (102.84±5.56) ml·100 ml-1·min-1, (20.31±2.03)%, (47.70±3.13) ml·100 ml-1·min-1, (135.55±4.53) ml/L, (68.08±1.05) 0.5 ml·100 ml-1·min-1, respectively. The data of ALP, PVP, HPI, BF, BV and P in the hepatic fibrosis group were (28.73±4.09) ml·100 ml-1·min-1, (94.14±5.56) ml·100 ml-1·min-1, (22.42±2.07)%, (40.95±3.94) ml·100 ml-1·min-1, (123.80±7.21) ml/L, (68.59±1.39) 0.5 ml·100 ml-1·min-1, respectively. Statistical analysis showed: the values of PVP, BF and BV in hepatic fibrosis group were lower than those of the control group, and the difference was significant (P＜0.05), and with the progress of hepatic fibrosis, they trended to decrease. The differences of PVP, BF and BV between stage S3, S4 and control group, stage S1 were statistically significant (P＜0.05), and the differences of the values between stage S2 and control group were also significant (P＜0.05). The values of HPI increased compared to the control group (P＜0.05), and with the different fibrosis degrees, it increased gradually. The difference of HPI between stage S3, S4 and control group, stage S1 was significant (P＜0.05). However, the means of ALP and P between groups were not statistically significant (P＞0.05). Conclusion Hepatic perfusion imaging with 64-slice spiral CT can reflect changes of hepatic blood perfusion of hepatic fibrosis and early stage of liver cirrhosis. The changes of the liver perfusion parameters were correlated with the severity of hepatic diffuse disease, and could be valuable for clinical early diagnosis, treatment and follow-up |
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