中华肝脏病杂志
中華肝髒病雜誌
중화간장병잡지
CHINESE JOURNAL OF HEPATOLOGY
2010年
4期
292-296
,共5页
王劲%罗琳%张建生%谢斯栋%刘凌云%姜在波%张亚琴%胡冰%单鸿%杨扬%陈规划%邝思驰
王勁%囉琳%張建生%謝斯棟%劉凌雲%薑在波%張亞琴%鬍冰%單鴻%楊颺%陳規劃%鄺思馳
왕경%라림%장건생%사사동%류릉운%강재파%장아금%호빙%단홍%양양%진규화%광사치
肝移植%肝动脉%体层摄影术,X线计算机
肝移植%肝動脈%體層攝影術,X線計算機
간이식%간동맥%체층섭영술,X선계산궤
Liver transplantation%Hepatic artery%Tomography,X-ray computed
目的 探讨320排CT中采用高浓度低剂量对比剂对移植肝动脉并发症的临床诊断价值.方法 58例肝移植术后患者,分A、B两组,对比剂分别为碘350g/L(27例)和370g/L(31例);均采用320排CT扫描机,对比剂流速均为6 ml/s,总剂量50 ml,采用动态容积扫描模式,扫描参数:X线管转速0.5 s/r,层厚0.5 mm,管电流100～250 mA,管电压100 kV.利用4D DSA成像软件,测量纯肝动脉的达峰时间、达峰CT值;记录肝移植组患者的身高和体质量.选取最佳纯肝动脉期的图像,进行容积(VR),最大密度投影(MIP),多层面图像重建(MPR).应用SPSS10.0统计分析软件,根据不同数据资料进行非参数检验,χ~2检验或t检验.结果 (1)肝移植A组,B组间的年龄、性别、身高、体质量和人体质量指数间比较,差异均无统计学意义,A组、B组间肝动脉达峰时间分别为(19.71±3.11)s、(20.06±3.67)s,两者间差异无统计学意义(P＞0.05);B组肝动脉达峰CT值、达峰绝对CT值分别为451.39±113.16、412.06±112.30,与A组的396.26±89.46、357.59±87.54相比,差异具有统计学意义(t值分别为-2.036、-2.038,P值均＜0.05);(2)移植肝动脉成像:肝动脉吻合口假性动脉瘤2例,肝动脉吻合口轻度、中度、重度狭窄、闭塞分别为13例、5例、9例、1例;肝动脉吻合口处多发中重度狭窄4例,肝动脉吻合口病变发生率为58.6%(34/58),肝动脉闭塞及重度狭窄者伴有肝门部侧支动脉形成6例,肝动脉-门静脉瘘及肝动脉迂曲各12例,肝内动脉小分支开放8例,其他包括15例伴有肝内动脉小分支稀疏,3例供受体肝动脉管径粗细不一致.结论 320排CT低剂量对比剂的4D DSA成像可获得准确的移植肝动脉纯动脉期图像,对肝移植术后肝动脉病变的诊断具有安全、无创、准确的优点,可作为肝移植术后对肝动脉并发症进行随访的有效手段.
目的 探討320排CT中採用高濃度低劑量對比劑對移植肝動脈併髮癥的臨床診斷價值.方法 58例肝移植術後患者,分A、B兩組,對比劑分彆為碘350g/L(27例)和370g/L(31例);均採用320排CT掃描機,對比劑流速均為6 ml/s,總劑量50 ml,採用動態容積掃描模式,掃描參數:X線管轉速0.5 s/r,層厚0.5 mm,管電流100～250 mA,管電壓100 kV.利用4D DSA成像軟件,測量純肝動脈的達峰時間、達峰CT值;記錄肝移植組患者的身高和體質量.選取最佳純肝動脈期的圖像,進行容積(VR),最大密度投影(MIP),多層麵圖像重建(MPR).應用SPSS10.0統計分析軟件,根據不同數據資料進行非參數檢驗,χ~2檢驗或t檢驗.結果 (1)肝移植A組,B組間的年齡、性彆、身高、體質量和人體質量指數間比較,差異均無統計學意義,A組、B組間肝動脈達峰時間分彆為(19.71±3.11)s、(20.06±3.67)s,兩者間差異無統計學意義(P＞0.05);B組肝動脈達峰CT值、達峰絕對CT值分彆為451.39±113.16、412.06±112.30,與A組的396.26±89.46、357.59±87.54相比,差異具有統計學意義(t值分彆為-2.036、-2.038,P值均＜0.05);(2)移植肝動脈成像:肝動脈吻閤口假性動脈瘤2例,肝動脈吻閤口輕度、中度、重度狹窄、閉塞分彆為13例、5例、9例、1例;肝動脈吻閤口處多髮中重度狹窄4例,肝動脈吻閤口病變髮生率為58.6%(34/58),肝動脈閉塞及重度狹窄者伴有肝門部側支動脈形成6例,肝動脈-門靜脈瘺及肝動脈迂麯各12例,肝內動脈小分支開放8例,其他包括15例伴有肝內動脈小分支稀疏,3例供受體肝動脈管徑粗細不一緻.結論 320排CT低劑量對比劑的4D DSA成像可穫得準確的移植肝動脈純動脈期圖像,對肝移植術後肝動脈病變的診斷具有安全、無創、準確的優點,可作為肝移植術後對肝動脈併髮癥進行隨訪的有效手段.
목적 탐토320배CT중채용고농도저제량대비제대이식간동맥병발증적림상진단개치.방법 58례간이식술후환자,분A、B량조,대비제분별위전350g/L(27례)화370g/L(31례);균채용320배CT소묘궤,대비제류속균위6 ml/s,총제량50 ml,채용동태용적소묘모식,소묘삼수:X선관전속0.5 s/r,층후0.5 mm,관전류100～250 mA,관전압100 kV.이용4D DSA성상연건,측량순간동맥적체봉시간、체봉CT치;기록간이식조환자적신고화체질량.선취최가순간동맥기적도상,진행용적(VR),최대밀도투영(MIP),다층면도상중건(MPR).응용SPSS10.0통계분석연건,근거불동수거자료진행비삼수검험,χ~2검험혹t검험.결과 (1)간이식A조,B조간적년령、성별、신고、체질량화인체질량지수간비교,차이균무통계학의의,A조、B조간간동맥체봉시간분별위(19.71±3.11)s、(20.06±3.67)s,량자간차이무통계학의의(P＞0.05);B조간동맥체봉CT치、체봉절대CT치분별위451.39±113.16、412.06±112.30,여A조적396.26±89.46、357.59±87.54상비,차이구유통계학의의(t치분별위-2.036、-2.038,P치균＜0.05);(2)이식간동맥성상:간동맥문합구가성동맥류2례,간동맥문합구경도、중도、중도협착、폐새분별위13례、5례、9례、1례;간동맥문합구처다발중중도협착4례,간동맥문합구병변발생솔위58.6%(34/58),간동맥폐새급중도협착자반유간문부측지동맥형성6례,간동맥-문정맥루급간동맥우곡각12례,간내동맥소분지개방8례,기타포괄15례반유간내동맥소분지희소,3례공수체간동맥관경조세불일치.결론 320배CT저제량대비제적4D DSA성상가획득준학적이식간동맥순동맥기도상,대간이식술후간동맥병변적진단구유안전、무창、준학적우점,가작위간이식술후대간동맥병발증진행수방적유효수단.
Objective To evaluate the clinical significance of 320-slice CT hepatic artery images in patients with liver transplantation.Methods A total of 58 patients underwent CT scanning by 320-slice scanner after liver transplantation.They were divided into 2 groups according to the concentration of contrast media as follows:Group A(27 cases,350 mgI/ml iopromide),Group B(31 cases,370 mgI/ml iopromide).Contrast medium was infused at 6 ml/s,with a total dose of 50 ml.Images were generated by dynamic volume scanning and were processed by 4D digital subtraction angiography(DSA)imaging software.The timedensity curve(TDC)of the hepatic artery was delineated.The time to peak,peal(contrast enhancement were recorded.The physiological parameters such as body weight and height were annlyzed.Results(1)There were no differences in clinical parameters such as age,sex,height,weight,or BMI between groups.The time to peak of hepatic artery of group A and B was(19.71±3.11)Sand(20.06±3.67)s,and had no significant difference.The maximum peak enhancement of hepatic artery in groups B was higher than that group A(P＜0.05).(2)4D DSA revealed hepatic artery pseudo-aneurysm(n=2),and hepatic artery mild stenosis(n=13),moderate stenosis(n=5),severe stenosis(n=9)and occlusion(n=1),segmental moderate and severe stenosis(n=4),and compensatory circulation with hepatic artery severe stenosis and occlusion(n=6).hepatoportal artefiovenous fistulas(HPAVF,n=12),donor-recipient hepmic artery mismatch(n=3).Hepatic arterial branch are decreased and opened in 15 cases and 8 cases.Conclusion 320-slice CT hepatic artery images is safe,noninvasive,and accurate technique to evaluate hepatic arterial complications after liver transplantation.
