肝硬化患者肺微循环多层螺旋CT灌注研究

摘要

目的:采用MSCT灌注成像技术研究肝硬化患者肺部微循环灌注参数的变化.材料和方法:对20例正常对照组、24例代偿期肝硬化组和19例失代偿期肝硬化组行16层螺旋CT肺部同层动态增强扫描后,在工作站上使用perfusion 3软件包对扫描数据进行处理,得出感兴趣区的时间-密度曲线(time-density curve,TDC)和各灌注参数值,包括血流量(blood flow,BF)、血容量(blood volume,BV)、对比剂平均通过时间(mean transit time,MTT)和表面渗透积乘积(permeability surface area product,PS).采用SPSS11.5软件包对上述数据进行统计学分析.结果:BF、BV值在各组的总体均数差别有统计学意义(P＜0.01).失代偿期肝硬化组的BF、BV值较正常对照组和代偿期肝硬化组都明显增加,组间差别有统计学意义(P＜0.01).代偿期肝硬化组的BF、BV值与正常对照组比较,组间差别无统计学意义(P＞0.05).MTT值各组的总体均数间差别有统计学意义(0.05＞P＞0.01).失代偿期肝硬化组的MTT值较正常对照组和代偿期肝硬化组减少,组间差别有统计学意义(0.05＞P＞0.01).PS值各组间差别无统计学意义(P＞0.05).结论:MSCT肺部微循环灌注成像技术可反映肝硬化患者病情程度.%Purpose To study the change of perfusion parameters of pulmonary microcirculation in different severity of liver cirrhosis with multi-slice CT (MS, CT). Materials and Methods Dynamic contrast- enhanced single-location sequence CT scans of the lung were obtained in 20 control subjects, 24 patients with compensated cirrhosis and 19 patients with decompensated cirrhosis. These data were processed on workstation using perfusion 3 software packages. The time-density curve (TDC) of region of interest and perfusion parameters of pulmonary microcirculation such as blood flow ( BF), blood volume (BV), mean transit time (MTT) and permeability surface area product(PS) were calculated. The parameters were statistically analysed. Results The population mean of BF and BV of pulmonary microcirculation were found statistically different between the three groups(P＜0. 01). Compared to control group and compensated cirrhosis group, the BF and BV of decompensated cirrhosis group significantly increased(all P＜0. 01). But there were no statistical differences between compensated cirrhosis group and control group in BF and BV(both P＞ 0. 05). The population mean of MTT between the three groups had statistical difference (0. 05＞P ＞0. 01) . Compared to control group and compensated cirrhosis group, the MTT of decompensated cirrhosis group significantly decreased(both 0. 05＞P ＞0. 01). The PS of pulmonary microcirculation between the three groups had no statistical significance (P＞ 0.05). Conclusion MSCT perfusion imaging of the pulmonary microcirculation can reflect the severity of liver cirrhosis.