慢性肝病的肝脏灌注参数：动态CT测量与疾病严重程度的相关性

Hepatic perfusion parameters in chronic liver disease: dynamic CT measurements correlated with disease severity.

作者信息

Van Beers B E, Leconte I, Materne R, Smith A M, Jamart J, Horsmans Y

机构信息

Department of Radiology, Université Catholique de Louvain, St-Luc University Hospital, Ave. Hippocrate 10, B-1200 Brussels, Belgium.

出版信息

AJR Am J Roentgenol. 2001 Mar;176(3):667-73. doi: 10.2214/ajr.176.3.1760667.

DOI:10.2214/ajr.176.3.1760667

PMID:11222202

Abstract

OBJECTIVE

The aim of our study was to determine if hepatic perfusion parameters measured with CT change in relation to disease severity in patients with chronic liver disease.

SUBJECTS AND METHODS

Dynamic contrast-enhanced single-section CT scans of the liver were obtained in 40 individuals who included six control subjects, 16 patients with noncirrhotic chronic liver disease, and 18 patients with cirrhosis. Hepatic, aortic, and portal venous time-density curves were fitted to a dual-input one-compartment model to calculate the liver perfusion, arterial fraction, distribution volume, and mean transit time.

RESULTS

Liver perfusion decreased in patients with cirrhosis (67 +/- 23 mL. min(-1). 100 mL(-1) versus 108 +/- 34 mL. min(-1). 100 mL(-1) in control subjects [p = 0.009] and 98 +/- 36 mL. min(-1). 100 mL(-1) in patients with noncirrhotic chronic liver disease [p = 0.003]), and the arterial fraction and the mean transit time increased (41 +/- 27% and 51 +/- 79 sec versus 17 +/- 16% and 16 +/- 5 sec in control subjects, and 19 +/- 6% and 17 +/- 8 sec in patients with noncirrhotic chronic liver disease [p < 0.05]). A significant correlation was seen between these three perfusion parameters and the severity of chronic liver disease based on clinical and biologic data (p < 0.001). No significant change in distribution volume was observed.

CONCLUSION

Hepatic perfusion parameters measured with CT were significantly altered in cirrhosis and correlated with the severity of chronic liver disease.

摘要

目的

我们研究的目的是确定慢性肝病患者中，通过CT测量的肝脏灌注参数是否随疾病严重程度而变化。

对象与方法

对40名个体进行肝脏动态对比增强单层面CT扫描，其中包括6名对照者、16名非肝硬化慢性肝病患者和18名肝硬化患者。将肝脏、主动脉和门静脉的时间-密度曲线拟合到双输入单室模型，以计算肝脏灌注、动脉分数、分布容积和平均通过时间。

结果

肝硬化患者的肝脏灌注降低（67±23 mL·min⁻¹·100 mL⁻¹，对照者为108±34 mL·min⁻¹·100 mL⁻¹ [p = 0.009]，非肝硬化慢性肝病患者为98±36 mL·min⁻¹·100 mL⁻¹ [p = 0.003]），动脉分数和平均通过时间增加（分别为41±27%和51±79秒，对照者为17±16%和16±5秒，非肝硬化慢性肝病患者为19±6%和17±8秒 [p < 0.05]）。基于临床和生物学数据，这三个灌注参数与慢性肝病的严重程度之间存在显著相关性（p < 0.001）。分布容积未观察到显著变化。