CAJ | 학술논문

目的：通过多层螺旋 CT(MSCT)全肝灌注模式,探讨正常肝脏 Couinaud 各段血流状态的特点。方法选择胃癌及胰腺恶性肿瘤患者73例,应用 MSCT 进行全肝灌注增强扫描,排除肝转移7例、多发肝囊肿(病灶直径>3 cm)6例、不同程度肝硬化6例、肝脏或脾脏手术史致肝段或脾缺如3例、肝内胆管扩张1例、运动伪影过大4例,最终纳入正常肝脏46例,并分别测定各段灌注参数值以评价正常肝脏各段的血流动力学状态。结果正常肝脏 S3段 HAP 与 S6、S7、S8以及 S4段 HAP 与 S7段存在统计学意义(P <0.05),S3段 HPI 与 S7段存在统计学意义(P <0.05)。在不同年龄组(A 组：<60岁,B 组：≥60岁)正常肝脏各段之间灌注参数值无统计学意义(P >0.05),但 A 组的血流灌注参数值大体高于 B 组。不同性别正常肝脏各段之间血流灌注参数值无统计学意义。结论正常肝脏各段的血流灌注情况不尽相同,MSCT 全肝脏灌注成像能更全面地反映正常肝脏血流动力学的变化,可为临床评估肝脏疾病提供影像学基础。
목적：통과다층라선 CT(MSCT)전간관주모식,탐토정상간장 Couinaud 각단혈류상태적특점。방법선택위암급이선악성종류환자73례,응용 MSCT 진행전간관주증강소묘,배제간전이7례、다발간낭종(병조직경>3 cm)6례、불동정도간경화6례、간장혹비장수술사치간단혹비결여3례、간내담관확장1례、운동위영과대4례,최종납입정상간장46례,병분별측정각단관주삼수치이평개정상간장각단적혈류동역학상태。결과정상간장 S3단 HAP 여 S6、S7、S8이급 S4단 HAP 여 S7단존재통계학의의(P <0.05),S3단 HPI 여 S7단존재통계학의의(P <0.05)。재불동년령조(A 조：<60세,B 조：≥60세)정상간장각단지간관주삼수치무통계학의의(P >0.05),단 A 조적혈류관주삼수치대체고우 B 조。불동성별정상간장각단지간혈류관주삼수치무통계학의의。결론정상간장각단적혈류관주정황불진상동,MSCT 전간장관주성상능경전면지반영정상간장혈류동역학적변화,가위림상평고간장질병제공영상학기출。
Objective To discuss the blood flow charateristics of normal Couinaud’s hepatic segments by using whole-liver perfu-sion with multi-slice spiral computed tomography (MSCT).Methods 73 patients underwent whole-liver perfusion enhanced CT scans for detection of gastric or pancreas cancer,and some were excluded including metastatic liver tumors in 7,multiple liver cysts (>3 cm in diameter)in 6,cirrhosis in 6,liver operation or splenecormy in 3,intra-hepatic bile duct dilation in 1,and excessive motion artifacts in 4.The final 46 patients with normal liver were included,and the perfusion parameters of liver segments were measured for estimating blood-dynamics condition.Results The hepatic arterial perfusion (HAP)in segment 3 was significantly higher than that in segment 6,7 and 8 (P <0.05),and the HAP in segment 4 was significantly higher than that in segment 7 (P <0.05).The hepatic perfusion index (HPI)in segment 3 was significantly higher than that in segment 7 (P <0.05).All normal liver were classi-fied into two groups (group A:<60 years,group B:≥60 years),and no significant correlation between age groups was found.How-ever,the perfusion parameter values in group A were higher than those in group B.No significant correlation was found between gen-ders.Conclusion Our results suggest that differences exist in normal hepatic parenchyma between liver segments.MSCT whole-liver perfusion imaging can more comprehensively response hemodynamic changes in liver,and provids the imaging basis for clinical evaluation of liver disease.