256层CT一站式检查评估肝硬化患者肝脏储备功能

发布时间：2018-06-13 07:52

本文选题：肝体积 + 全肝灌注成像　；参考：《南京医科大学学报(自然科学版)》2015年03期

【摘要】：目的 :探讨全肝灌注+肝脏体积一站式检查评价肝硬化患者肝脏储备功能的应用价值。方法 :肝功能正常组20例及肝硬化组23例均行256层CT全肝灌注和常规上腹部增强扫描,将灌注数据和增强门脉期薄层数据分别经Functional软件及肝段分析处理后,得出全肝灌注参数值和体积值,取各段灌注参数平均值作为全肝灌注参数值。对肝硬化组应用Child-pugh(C-P)分级进行分组,比较肝功能正常组与Child A、B、C各组间肝脏体积、全肝灌注参数的差异;并计算得出综合指标,分别与肝功能C-P分级分数进行相关性分析。结果:随着肝功能受损程度的加重,肝动脉灌注量(hepatic arterial perfusion,HAP)、肝动脉灌注指数(hepatic arterial perfusion index,HAPI)呈逐级上升,门静脉灌注量(hepatic portal perfusion,HPP)、肝总灌注量(total liver perfusion,TLP)、门静脉灌注指数(hepatic portal perfusion index,HPPI)呈逐级递减,相关性系数分别为:rHAP=0.382,rHAPI=0.841,rHPP=-0.761,rTLP=-0.594,rHPPI=-0.846;肝脏体积(liver volume,LV)、单位体表面积肝脏体积(liver volume per body surface area,LVs)呈逐级递减,rLV=-0.875,rLVs=-0.933;单位体表面积肝脏体积-门静脉灌注指数(volume hepatic portal perfusion index per body surface area,VHPPILs)呈逐级递减,rVHPPILs=-0.945。结论 :肝血流灌注及肝体积的改变与肝硬化临床分级相关,VHPPILs综合指标更全面地诠释了肝脏储备功能,可用于定量评估肝硬化患者肝脏整体储备功能。
[Abstract]:Objective: to evaluate the value of one-stop liver perfusion volume test in evaluating liver reserve function in patients with liver cirrhosis. Methods: 20 cases of normal liver function group and 23 cases of liver cirrhosis group underwent 256-slice CT whole liver perfusion and routine upper abdominal enhanced scanning. The perfusion data and enhanced portal phase thin layer data were analyzed by functional software and hepatic segment analysis, respectively. The whole liver perfusion parameters and volume values were obtained, and the average perfusion parameters were taken as the whole liver perfusion parameters. The liver volume and perfusion parameters were compared between normal liver function group and Child Afib C group, and the comprehensive indexes were calculated, and the correlation between liver function C-P score and liver function C-P score was analyzed. Results: with the severity of liver function damage, hepatic arterial perfusion volume and hepatic artery perfusion index (HAPI) increased step by step, and portal vein perfusion volume was increased gradually, total liver perfusion volume was increased, total liver perfusion volume and hepatic portal perfusion index (HPPI) were decreased step by step, respectively, and hepatic arterial perfusion index (HAPI) was decreased gradually, and hepatic arterial perfusion index (HAPI) was decreased gradually with hepatic arterial perfusion (HAPI), hepatic portal perfusion index (HAPI), total liver perfusion volume (TLP), hepatic artery perfusion index (HAPI) and hepatic perfusion index (HAPI). The correlation coefficients were 0.841 ~ 0. 761 ~ 0. 761 ~ 0. 761 ~ 0. 594 ~ 0. 594 ~ 0. 594 ~ 0. 594 ~ 0. 846 rHPPIP ~ 0. 846, respectively. The volume of liver volume and volume of volume per body surface were decreased gradually, rLV- 0. 875 ~ 0. 875 ~ 0. 933 and rVHPPILs / volume / volume of portal vein perfusion / volume / portal vein perfusion index / volume / portal vein perfusion index (hepatic portal perfusion index per body surface / VHPPILs) were gradually decreased respectively (r LVL = 0. 382%) and rVHPPILs (r = 0. 875%) and rVHPPILs (n = 0. 945) respectively. The correlation coefficients were 0. 842% (n = 10) and 0. 841% (n = 10), respectively. Conclusion: the changes of hepatic blood flow perfusion and liver volume are related to the clinical grade of liver cirrhosis. The comprehensive indexes of VHPPILs can be used to quantitatively evaluate the liver reserve function in patients with liver cirrhosis.
【作者单位】：南通大学第三附属医院放射科;河北省邯郸市中心医院CT室;
【基金】：无锡市医院管理中心医学技术重大项目(YGZF1108)
【分类号】：R575.2

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