CAJ | 학술논문

目的：探讨能谱CT容积螺旋穿梭灌注成像联合体积测量评价肝硬化肝功能储备的应用价值。方法肝硬化组30例及正常肝脏组30例均行 CT 肝体积测量和灌注成像,比较肝硬化组与正常肝脏组之间,肝硬化组肝功能 A、B、C 级之间的肝体积值,血流灌注参数值及肝体积-血流灌注乘积参数值的差异,并将肝功能分级分数与肝体积值、血流灌注参数值及肝体积-血流灌注综合参数值作相关性分析。结果肝硬化组 A、B、C 级肝体积(LV )呈逐级递减,各组间有统计学差异(P <0.01)；肝硬化组血流灌注参数的肝血流量(BF)、肝血容量(BV)、平均通过时间(MTT)、肝动脉分数(HAF)与正常肝脏组相比,差异有统计学意义(P <0.01)；BF 和 BV 呈逐级递减,C 级与 A、B 级间有统计学差异(P <0.01)；肝体积-血流灌注指数(VBPI)呈逐级递减,各级间有统计学差异(P <0.01)；与其他指标相比,VBPI 与肝功能分级具有更高的相关性(r=-0.835,P <0.01)。结论肝体积及肝血流灌注参数的改变与肝硬化的临床分级相关,能谱 CT 容积螺旋穿梭灌注成像联合体积测量能准确地评价肝储备功能。
목적：탐토능보CT용적라선천사관주성상연합체적측량평개간경화간공능저비적응용개치。방법간경화조30례급정상간장조30례균행 CT 간체적측량화관주성상,비교간경화조여정상간장조지간,간경화조간공능 A、B、C 급지간적간체적치,혈류관주삼수치급간체적-혈류관주승적삼수치적차이,병장간공능분급분수여간체적치、혈류관주삼수치급간체적-혈류관주종합삼수치작상관성분석。결과간경화조 A、B、C 급간체적(LV )정축급체감,각조간유통계학차이(P <0.01)；간경화조혈류관주삼수적간혈류량(BF)、간혈용량(BV)、평균통과시간(MTT)、간동맥분수(HAF)여정상간장조상비,차이유통계학의의(P <0.01)；BF 화 BV 정축급체감,C 급여 A、B 급간유통계학차이(P <0.01)；간체적-혈류관주지수(VBPI)정축급체감,각급간유통계학차이(P <0.01)；여기타지표상비,VBPI 여간공능분급구유경고적상관성(r=-0.835,P <0.01)。결론간체적급간혈류관주삼수적개변여간경화적림상분급상관,능보 CT 용적라선천사관주성상연합체적측량능준학지평개간저비공능。
Objective To investigate the application value of hepatic volume measurement combined with perfusion imaging using spectral CT volume helical shuttle scanning in evaluating the hepatic functional reserve in cirrhosis.Methods CT volume measure-ment of liver and CT perfusion imaging were performed in 30 patients with cirrhosis and in other 30 subjects with normal liver.The hepatic volume,parameters of blood flow perfusion and liver volume-perfusion index were observed and analyzed.Correlations be-tween graded fractions of hepatic function and liver volume,parameters of perfusion and liver volume-perfusion index were also ana-lyzed.Results The liver volume (LV)reduced gradually (P <0.01)with the grading of hepatic function from Grade A to C.There were significantly statistical differences in blood flow (BF),blood volume (BV)and hepatic arterial fraction (HAF)between the nor-mal liver and cirrhosis.Differences in BF and BV were significant between Grade C and Grade A or B (P <0.01).The liver volume-blood perfusion index (VBPI)reduced gradually with the grading from Grade A to C (P<0.01).The correlation of liver volume-per-fusion index with graded fractions of hepatic function was higher than that among other indexes.Conclusion Changes of volume and blood flow perfusion of the liver are related to the clinical grading of hepatic function.The volume measurement combined with spec-tral CT volume helical shuttle perfusion scanning will be a more comprehensive way in evaluating hepatic functional reserve.