肝硬化640层CT肝灌注容积扫描肝血管成像的临床应用研究

发布时间：2018-01-08 04:33

本文关键词：肝硬化640层CT肝灌注容积扫描肝血管成像的临床应用研究　出处：《放射学实践》2016年12期 　论文类型：期刊论文

【摘要】：目的:探讨利用640层CT肝灌注容积数据对肝硬化患者进行肝血管成像的可行性及其临床应用价值。方法:25例肝功正常(A组)和50例肝硬化患者(B组:Child-Pugh A级25例;C组:Child-Pugh B级25例)行640层CT肝灌注检查,绘制时间-密度曲线(TDC),测量主动脉和门静脉的达峰值时间(TTP)、峰值(PV)及门静脉与肝脏密度差的最大值(P-L)。选取主动脉峰值期的容积数据进行肝动脉血管成像;采用P-L值最大的1期及3期容积数据对门静脉进行单期和多期融合成像,并对比两种成像方法的图像质量。结果:三组间主动脉TTP和PV的差异均无统计学意义(P0.05)。肝硬化组门静脉的TTP较对照组长,PV及P-L值下降,3组间差异有统计学意义(P0.05);进一步两两比较,除A与B组间门脉TTP值的差异无统计学意义外,其余各组间3个参数的差异有统计学意义(P0.05)。3组均可显示肝动脉3级分支。门脉多期融合成像质量优于单期成像(P0.05),A组可显示3~4级门静脉分支,B和C组可显示1~3级门静脉分支。结论:利用640层CT全肝灌注成像容积数据进行血管成像,能清晰显示肝动脉和门静脉,有助于肝硬化患者临床治疗方案的制订。
[Abstract]:Objective: to investigate the feasibility and clinical value of hepatic angiography with 640 slice CT perfusion volume data in patients with liver cirrhosis. Methods: 25 patients with normal liver function (group A) and 50 patients with liver cirrhosis (n = 50) were enrolled in this study. Group B: 25 cases of Child-Pugh A grade; Group C: 25 cases with Child-Pugh B grade) underwent 640slice CT hepatic perfusion examination. The time-density curve was plotted and the peak time of aorta and portal vein was measured. Peak PVV) and the maximum density difference between portal vein and liver (P-L). The volume data of peak aortic phase were selected for hepatic artery angiography. One-phase and multi-phase fusion imaging of portal vein was performed by using the volume data of phase 1 and phase 3 with the largest P-L value. Results: there was no significant difference in aortic TTP and PV among the three groups. The TTP of portal vein in cirrhosis group was longer than that in control group. There were significant differences in PV and P-L values among the three groups (P 0.05). Further comparison showed that there was no significant difference in portal TTP between group A and group B. The difference of three parameters among the other groups was statistically significant. The hepatic artery grade 3 branches could be displayed in group P0.05. the quality of portal multi-phase fusion imaging was better than that of single-phase imaging (P0.05). Group A could display 3 grade 4 portal branch B and C group could display 1 grade 3 grade 3 portal vein branch. Conclusion: the total hepatic perfusion volume data of 640 slice CT were used for angiography. It can clearly display hepatic artery and portal vein, which is helpful for the clinical treatment of liver cirrhosis patients.
【作者单位】：云南省第二人民医院放射科;上海复旦大学附属中山医院放射科;
【基金】：云南省教育厅科学研究一般项目(2011Y204)
【分类号】：R575.2;R816.5
【正文快照】： 肝硬化在我国发病率较高,可并发肝癌、引起上消化道大出血等而危及患者的生命。全面了解肝脏的代偿功能、肝内血管及病变的情况,对治疗方案的制定和预后评估至关重要。肝灌注成像作为一种功能成像方法,可通过评估肝血流动力学的改变来评估肝脏功能,在临床应用前景较好。随着CT

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