CAJ | 학술논문

目的探讨超声造影反映肝硬化进程中肝血流灌注的变化规律.方法对40例肝硬化患者(病例组)和25例健康人(对照组)进行超声造影检查,应用QLAB分析软件,将肝实质作为感兴趣区绘制时间-强度曲线,测量肝动脉灌注时间(Tap)及肝动脉灌注强度(Iap),肝实质灌注达峰时间(Tpeak)及肝实质灌注峰值强度(Ipeak),门静脉灌注达峰时间(Tpp,Tpp=Tpeak,-Taf)及门静脉灌注强度(Ipp,Ipp=Ipaek -Iaf),计算Ipp/Ipeak值.比较两组间Iap、Ipeak、Ipp及Ipp/Ipeak的差异,并应用受试者操作特性(ROC)曲线进行分析.结果病例组与对照组比较,Iap增大(P＜0.001),Ipp、Ipp/Ipaek均缩小(P ＜0.001).而Ipeak在两组间差异无统计学意义.Iap、Ipp、Ipp/Ipeak诊断肝硬化的灵敏度分别为67.3％、92.7％、96.4％,特异度分别为80.0％、96.0％、92.3％.结论超声造影参数可以反映肝硬化肝血流灌注的变化,尤其Ipp/Ipeak在肝硬化和正常肝之间存在显著差异.
목적 탐토초성조영반영간경화진정중간혈류관주적변화규률.방법 대40례간경화환자(병례조)화25례건강인(대조조)진행초성조영검사,응용QLAB분석연건,장간실질작위감흥취구회제시간-강도곡선,측량간동맥관주시간(Tap)급간동맥관주강도(Iap),간실질관주체봉시간(Tpeak)급간실질관주봉치강도(Ipeak),문정맥관주체봉시간(Tpp,Tpp=Tpeak,-Taf)급문정맥관주강도(Ipp,Ipp=Ipaek -Iaf),계산Ipp/Ipeak치.비교량조간Iap、Ipeak、Ipp급Ipp/Ipeak적차이,병응용수시자조작특성(ROC)곡선진행분석.결과 병례조여대조조비교,Iap증대(P＜0.001),Ipp、Ipp/Ipaek균축소(P ＜0.001).이Ipeak재량조간차이무통계학의의.Iap、Ipp、Ipp/Ipeak진단간경화적령민도분별위67.3％、92.7％、96.4％,특이도분별위80.0％、96.0％、92.3％.결론 초성조영삼수가이반영간경화간혈류관주적변화,우기Ipp/Ipeak재간경화화정상간지간존재현저차이.
Objective To evaluate hepatic perfusion assessed by contrast-enhanced ultrasonography (CEUS) for predicting cirrhosis accurately and non-invasively.Methods Forty patients with cirrhosis and twenty-five healthy controls were given CEUS examination,and time-intensity curves were drawn as the regions of interest located in liver parenchyma by using QLAB analyzing soft.The parameters of the two groups as follows:intensity of arterial perfusion (Iap),intensity of total perfusion of liver parenchyma (Ipeak),intensity of portal venous perfusion (Ipp),the ratio of portal venous perfusion and total perfusion (Ipp/Ipeak) were compared by independent-samples t test,and the diagnostic value of parameters were analyzed by receiver operating characteristic (ROC) curve.Resnlts Iap was bigger,while Ipp,Ipp/Ipeak were smaller in patients than that in controls( P ＜0.001 ).But there was no significant difference on Ipeak between the two groups.When Iap,Ipp,Ipp/Ipeak were used for the diagnosis of cirrhosis,the sensitivity were 67.3 ％,92.7％,96.4％ and the specificity were 80.0％,96.0％,92.3％,respectively.Conclusions CEUS can reflect the changes of the blood perfusion of cirrhotic liver.CEUS parameters Iap,Ipp,Ipp/Ipeak are significant different between the two groups and can be the non-invasive diagosis parameters of cirrhosis.