16层螺旋CT灌注成像对肝硬化血流状态的评估及与肝硬化程度的相关性研究

目的:探讨16层螺旋CT灌注成像对肝硬化血流状态的评估价值及其与肝硬化程度的相关性。方法:选取2014年1月至2016年1月于我院接受诊治的肝硬化患者126例作为肝硬化组,根据Child-Pugh分级分为A组(Child A级,n=35例)、B组(Child B级,n=50例)、C组(Child C级,n=41例)。另选取同期于我院接受体检的健康人员100例作为对照组。应用16层螺旋CT对受试者肝脏、脾脏、主动脉以及门静脉的层面进行CT动态增强扫描,对比CT灌注参数,采用Pearson相关性分析分析CT灌注参数与肝硬化病情严重程度的关系。结果:肝硬化组肝动脉灌注量(HAP)、肝动脉灌注指数(HPI)、肝脏血流量(TBV)以及平均通过时间(MTT)均明显高于对照组,而门静脉灌注量(PVP)、总肝灌注量(TLP)均明显低于对照组(P0.05)。A组患者HAP、HPI均明显高于C组,而PVP与TLP均明显低于C组,差异有统计学意义(P0.05);两组TBV、MTT比较无统计学差异(P0.05);而A组与B组相比以及B组与C组相比,各项CT灌注参数均无统计学差异(P0.05)。肝硬化患者病情严重程度与HAP、HPI均呈正相关关系(P0.05),而与PVP、TLP均呈负相关关系(P0.05)。结论:16层螺旋CT灌注成像对肝硬化血流状态具有一定的评估价值,且CT灌注参数的水平变化与肝硬化患者病情严重程度存在密切相关。

Evaluation of the Flow Status of Liver Cirrhosis with 16 Slice Spiral CT Perfusion Imaging and its Correlation with the Degree of Cirrhosis

ABSTRACT Objective: To investigate the evaluation of the flow status of liver cirrhosis with 16 slice spiral CT perfusion imaging and its correlation with the degree of cirrhosis. Methods: 126 patients with liver cirrhosis who were treated in our hospital from January 2014 to January 2016 as cirrhosis group, the patients were divided into group A (Child A, n=35), group B (Child B, n=50), group C (Child C, n=43) according to Child-Pugh. Another 100 healthy people who received physical examination in our hospital were selected as the control group. 16 slice spiral CT was used to perform dynamic contrast-enhanced CT scan on the liver, spleen, aorta and portal vein of the subjects, the CT perfusion parameters were compared. Pearson correlation analysis was used to analyze the relationship between CT perfusion parameters and severity of liver cirrhosis. Results: The hepatic artery perfusion volume (HAP), hepatic artery perfusion in- dex (HPI), hepatic blood flow (TBV) and mean transit time (MTT) were significantly higher in the cirrhosis group than those in the con- trol group, portal vein perfusion (PVP) and total hepatic perfusion (TLP) were significantly lower than those in the control group (P<0.05). The HAP and HPI in group A were significantly higher than those in group C, PVP and TLP were significantly lower than those in group C, the differences were statistically significant (P<0.05). There was no significant difference in TBV and MTT between the two groups (P>0.05). and group A compared with group B, group B compared with group C, there was no statistical difference in CT perfu- sion parameters (P>0.05). The severity of liver cirrhosis was positively correlated with HAP and HPI (P<0.05), but negatively correlated with PVP and TLP (P<0.05). Conclusion: 16 slice spiral CT perfusion imaging has certain value in evaluating the blood flow status of cir- rhosis, and the level of CT perfusion parameters is closely related to the severity of cirrhosis.