256层CT全肝灌注评估肝硬化段性功能储备

发布时间：2018-08-29 14:32

【摘要】：目的:以临床Ch ild-pug h分级为标准,应用256层CT全肝灌注扫描对肝硬化患者行段性功能储备评估。方法:20例无明显肝脏疾患的患者及23例肝硬化患者均行全肝灌注检查,得到肝脏灌注图像,分别测量肝脏各段灌注参数:肝动脉灌注量(HAP)、门静脉灌注量(HPP)、肝总灌注量(TLP)、肝动脉灌注指数(HAPI)以及门静脉灌注指数(HPPI)。对正常组及肝硬化组行肝段性灌注测量,对肝脏各段血流灌注参数行统计学分析。结果:正常肝脏各段间HAP、HPP、TLP、HAPI、HPPI均无统计学差异,HAP:HPP=1/3~1/4;Ch ild-pug h A级H A P、T LP存在段间差异(P0.05),H A P:H PP=1/2~1/3;Ch ild-pug h B级H A P存在段间差异(P0.05),HAP:HPP=1/2~1/3;Child-pugh C级各灌注参数均存在段间差异(P0.05),HAP:HPP=2/1~2/3。正常组与肝硬化各组间比较:除Ⅱ、Ⅲ段HAP组间无统计学差异外,Ⅰ-Ⅷ段各灌注参数均存在部分组间差异(P0.05),Ⅰ-Ⅷ段HPP肝硬化各组与正常组均有统计学差异,随着肝功能受损程度的加重,肝脏各段HAP、HAPI值呈上升趋势,HPP、TLP、HPPI值呈下降趋势,肝动脉与门静脉系统血供比例逐渐增大。结论:256层CT全肝灌注模式可用于直观定量反映肝硬化肝脏各段血流灌注特征,对肝脏储备功能分段评估具有一定临床应用价值。
[Abstract]:Objective: to evaluate segmental functional reserve in patients with liver cirrhosis by 256-slice CT total hepatic perfusion scan according to clinical Ch ild-pug h grade. Methods Twenty patients without obvious liver disease and 23 patients with liver cirrhosis were examined with whole liver perfusion, and liver perfusion images were obtained. Hepatic perfusion parameters: hepatic artery perfusion (HAP), portal vein perfusion (HPP), total hepatic perfusion (TLP), hepatic artery perfusion index (HAPI) and portal vein perfusion index (HPPI). Hepatic segmental perfusion was measured in normal group and liver cirrhosis group. Results: there was no significant difference in HAP,HPP,TLP,HAPI,HPPI between normal liver segments (P 0.05). There was no significant difference in HAP,HPP,TLP,HAPI,HPPI between different segments of HPA: HPA: 1 / 3 / 1 / 4% Ch ild-pug h / H A LP (P0.05). (P0.05) there were significant differences in HPA: HPA: h / H PP=1/2~1/3;Ch ild-pug h / B H A P between segments (P0.05). (P0.05) there were significant differences in the perfusion parameters of HPA: HPA: HPP1 / 21- / 3Child-pugh C (P0.05). Comparison between normal group and cirrhosis group: except that there was no statistical difference between 鈪，

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