Koranda P, Myslivecek M, Erban J, Seidlová V, Husák V
Department of Nuclear Medicine, University Hospital, Olomouc, Czech Republic.
Clin Nucl Med. 1999 Jul;24(7):507-10. doi: 10.1097/00003072-199907000-00007.
This study used radionuclide angiography to evaluate semiquantitatively the hepatic arterial blood flow changes associated with cirrhosis.
The parameters of net arterial hepatic perfusion were estimated by analysis of first-pass flow studies in 11 control participants and in 15 patients with cirrhosis (Child-Pugh classification B-C). Hepatic, renal, and splenic time-activity curves were generated, normalized per pixel, and corrected for background. The rate of hepatic arterial blood flow was compared with the reference kidney and spleen perfusion using the hepatorenal and hepatolienal perfusion indices, respectively. These indices were defined as: PI = area under hepatic curve limited by time of the renal (splenic) curve peak/area under renal (splenic) curve to its peak
The values of both these perfusion indices are significantly greater in the patients with cirrhosis than in controls (hepatorenal perfusion index, P < 0.01; hepatolienal perfusion index, P < 0.05). The values of the hepatic perfusion index (the ratio of the arterial to the total liver blood flow), which were also calculated, were elevated in the patients with cirrhosis (P < 0.01).
The results confirm that the net hepatic arterial blood flow is increased in patients with cirrhosis. Radionuclide angiography accompanied by calculation of arterial perfusion indices may provide semiquantitative parameters of net hepatic arterial blood flow.
本研究采用放射性核素血管造影术对与肝硬化相关的肝动脉血流变化进行半定量评估。
通过对11名对照参与者和15名肝硬化患者（Child-Pugh分级为B - C级）的首过血流研究分析，估算肝动脉净灌注参数。生成肝脏、肾脏和脾脏的时间 - 活性曲线，按像素进行归一化，并校正背景。分别使用肝肾灌注指数和肝脾灌注指数，将肝动脉血流速率与参考肾脏和脾脏灌注进行比较。这些指数定义为：PI = 肝脏曲线下由肾脏（脾脏）曲线峰值时间限定的面积/肾脏（脾脏）曲线至其峰值的面积
肝硬化患者的这两个灌注指数值均显著高于对照组（肝肾灌注指数，P < 0.01；肝脾灌注指数，P < 0.05）。计算得出的肝灌注指数（肝动脉血流与肝脏总血流的比值）在肝硬化患者中也升高（P < 0.01）。
结果证实肝硬化患者的肝动脉净血流增加。放射性核素血管造影术结合动脉灌注指数计算可为肝动脉净血流提供半定量参数。
