Tsushima Y, Blomley M J, Yokoyama H, Kusano S, Endo K
Department of Radiology, National Defense Medical College, Tokorozawa, Saitama, Japan.
Dig Dis Sci. 2001 Oct;46(10):2113-9. doi: 10.1023/a:1011990226667.
Our objective was to investigate if hepatic arterial (HAP) and portal venous perfusion (PVP) in apparently normal areas of liver, as measured by functional CT, are affected by the presence of extra- and intrahepatic malignancy Three patient groups were compared: A, controls with no malignancy (N = 10); B, extrahepatic malignancy without liver involvement (N = 12); and C, subjects with metastases elsewhere in the liver (N = 13). HAP, PVP, and a CT hepatic perfusion index (CT-HPI) calculated as HAP/(HAP + PVP) were calculated on a section free of metastatic disease, using a previously published method. Figures for PVP were (median and interquartile range) in group A were 1.06 (0.9-1.30), in B 1.03 (0.81-1.09), and in C 0.75 (0.54-1.02) ml/min/ml; for HAP group A values were 0.07 (0.052-0.078), in B 0.07 (0.053-0.147), and in C 0.12 (0.091-0.146) ml/min/ml and for CT-HPI Group A values were 4.9% (4.8-6.6%), in B 5.6% (3.8-13.6%), and in C 14.3% (10.4-15.4%). Significant differences in all indices were seen between groups A and C. A significant difference (P = 0.017) was seen between groups B and C in the CT-HPI values. In conclusion, patients with liver metastases show abnormal blood flow in apparently normal liver compared to controls. This difference was not seen in subjects with malignancy without liver metastases. Possible explanations would be either the unmasking of occult metastatic disease or vasoactive or mechanical effects due to liver malignancy.
我们的目的是研究通过功能性CT测量的肝脏明显正常区域的肝动脉灌注（HAP）和门静脉灌注（PVP）是否会受到肝内和肝外恶性肿瘤的影响。比较了三组患者：A组，无恶性肿瘤的对照组（N = 10）；B组，无肝脏受累的肝外恶性肿瘤患者（N = 12）；C组，肝脏其他部位有转移的患者（N = 13）。使用先前发表的方法，在无转移病灶的切片上计算HAP、PVP以及以HAP/（HAP + PVP）计算的CT肝脏灌注指数（CT-HPI）。PVP的数据（中位数和四分位间距）在A组为1.06（0.9 - 1.30），B组为1.03（0.81 - 1.09），C组为0.75（0.54 - 1.02）ml/min/ml；HAP的值在A组为0.07（0.052 - 0.078），B组为0.07（0.053 - 0.147），C组为0.12（0.091 - 0.146）ml/min/ml；CT-HPI的值在A组为4.9%（4.8 - 6.6%），B组为5.6%（3.8 - 13.6%），C组为14.3%（10.4 - 15.4%）。A组和C组之间在所有指标上均存在显著差异。B组和C组之间在CT-HPI值上存在显著差异（P = 0.017）。总之，与对照组相比，肝转移患者的肝脏明显正常区域血流异常。在无肝转移的恶性肿瘤患者中未观察到这种差异。可能的解释要么是隐匿性转移病灶的暴露，要么是肝脏恶性肿瘤引起的血管活性或机械效应。
