双源CT全肝低剂量灌注成像对肝硬化门静脉高压患者经颈静脉肝内门体分流术后肝血流灌注的评估价值

翟亚楠; 李雷; 殷亮; 郭奇虹; 雷军强; 郭顺林; 张春雨; 王海军; 温晓晓

doi:10.3969/j.issn.1001-5256.2016.10.014

双源CT全肝低剂量灌注成像对肝硬化门静脉高压患者经颈静脉肝内门体分流术后肝血流灌注的评估价值

DOI: 10.3969/j.issn.1001-5256.2016.10.014

1. 兰州大学第一医院放射科
2. 兰州大学第一医院介入科
3. 甘肃省卫生职业学院医学影像教研室
4. 甘肃省人民医院核医学科
5. 甘肃省妇幼保健院辅助生殖医学中心

基金项目:

兰州大学第一医院2015年度院内青年基金(ldyyyn2015-13)；

详细信息

中图分类号: R575.2;R816.5
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出版历程
- 出版日期: 2016-10-20

Role of dual-source CT low-dose whole liver perfusion imaging in evaluating liver blood perfusion after transjugular intrahepatic portosystemic shunt in cirrhotic patients with portal hypertension

Department of Radiology, The First Hospital of Lanzhou University

Research funding:

摘要

摘要:
目的利用双源CT低剂量全肝灌注扫描技术观察肝硬化门静脉高压经颈静脉肝内门体分流术（TIPS）术前、术后肝实质血流动力学改变。方法收集2014年10月-2016年5月期间于兰州大学第一医院准备接受TIPS治疗的肝硬化门静脉高压患者52例,TIPS术前2 d及术后1周接受全肝灌注CT扫描,评价图像质量并利用后处理工作站观察灌注参数变化。计量资料组间比较采用配对t检验,各参数之间相关性分析采用Pearson直线相关分析法。结果肝脏动脉灌注量（HAP）由术前（19.85±9.48）ml/（min·100 ml）升高为（29.36±13.65）ml/（min·100 ml）,肝动脉灌注指数（HPI）由术前（54.32±19.60）%升高为（64.11±11.19）%,差异均有统计学意义（t值分别为-6.161、-6.202,P值分别为0.003、0.029）;而门静脉灌流量（PVP）由术前（19.75±10.60）ml/（min·100 ml）下降为（16.13±8.60）ml/（min·100 ml）,总肝灌注量（TLP）由术前（36.14±16.61）ml/（min·100 ml）上升为（4...
- 肝硬化 /
- 高血压,门静脉 /
- 体层摄影术,X线计算机 /
- 门体分流术,经颈静脉肝内
Abstract:
Objective To investigate the role of dual-source CT low-dose whole liver perfusion imaging in evaluating the hemodynamic changes in liver parenchyma before and after transjugular intrahepatic portosystemic shunt( TIPS) in cirrhotic patients with portal hypertension. Methods A total of 52 cirrhosis patients with portal hypertension underwent whole liver perfusion CT scan 2 days before TIPS and at1 week after TIPS. The image quality was evaluated and a post-processing workstation was used to observe the changes in perfusion parameters. Paired t-test was applied for comparison between two groups,and pearson linear correlation was applied for correlation analysis. Results Hepatic arterial perfusion( HAP) increased from 19. 85 ml /( min·100 ml) ± 9. 48 ml /( min·100 ml) before TIPS to 29. 36 ml /( min·100 ml) ± 13. 65 ml/( min·100 ml) after TIPS( t =-6. 161,P = 0. 003),and the hepatic arterial perfusion index( HPI) increased from 54. 32% ± 19. 60% before TIPS to 64. 11% ± 11. 19% after TIPS( t =-6. 202,P = 0. 029). Portal vein perfusion( PVP)was reduced from 19. 75 ml /( min·100 ml) ± 10. 60 ml /( min·100 ml) before TIPS to 16. 13 ml /( min·100 ml) ± 8. 60 ml /( min·100ml) after TIPS,and total liver perfusion( TLP) increased from 36. 14 ml /( min ·100 ml) ± 16. 61 ml /( min ·100 ml) before TIPS to44. 12 ml /( min·100 ml) ± 14. 60 ml /( min·100 ml) after TIPS( both P > 0. 05). The mean effective radiation dose of whole liver perfusion scan was 16. 5 m Sv. PVP,TLP,and HPI were significantly correlated with the injection rate of contrast agent( r = 0. 992,P = 0. 001; r=-0. 903,P = 0. 036; r =-0. 899,P = 0. 038). HAP,PVP,and TLP were negatively correlated with the sample size( r =-0. 922,P =0. 026; r =-0. 943,P = 0. 016; r =-0. 998,P < 0. 001). TLP was positively correlated with the voltage of X-ray tube and scantimes( r =0. 896,P = 0. 039; r = 0. 907,P = 0. 033). Conclusion Dual-source CT low-dose whole liver perfusion can be used to observe the hemodynamic changes in cirrhotic patients with portal hypertension before and after TIPS and provide a reference for preoperative evaluation and therapeutic effect evaluation.
- liver cirrhosis /
- hypertension /
- portal /
- tomograpy

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参考文献(17)

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