Tsushima Yoshito, Blomley Martin J K, Kusano Shoichi, Endo Keigo
Department of Radiology, National Defense Medical College, Saitama, Japan.
Acad Radiol. 2002 Mar;9(3):276-82. doi: 10.1016/s1076-6332(03)80370-7.
Two algorithms can be used to measure portal venous perfusion (PVP) with contrast material-enhanced single-level liver computed tomography. The "direct" and "indirect" algorithms use data from the portal vein and aorta, respectively. This study compared PVP values obtained with direct and with indirect algorithms in a series of patients.
Both techniques were applied in 27 patients with cirrhosis (14 men and 13 women; mean age, 56.1 years +/- 9.4) and 18 control patients (seven men and 11 women; 52.8 years +/- 12.3). A single section through the liver was scanned after intravenous injection of ioversol (40-mL bolus; 320 mg of iodine per milliliter).
Both techniques showed reduced PVP in patients with cirrhosis (0.63 for direct and 0.17 for indirect method) compared with control patients (1.06 and 0.26, respectively), but only the direct method agreed with physiologic expectations based on animal and human studies. In separating cirrhotic and control patients, the area under the receiver operating characteristic curve was significantly greater for the direct method (0.91 vs 0.78; P = .03).
Both direct and indirect methods are feasible and distinguish well between cirrhotic and control patients, but the direct method is more physiologic and is preferable if portal venous data are available.
两种算法可用于通过对比剂增强的单层肝脏计算机断层扫描来测量门静脉灌注（PVP）。“直接”算法和“间接”算法分别使用来自门静脉和主动脉的数据。本研究比较了一系列患者中使用直接算法和间接算法获得的PVP值。
两种技术应用于27例肝硬化患者（14例男性和13例女性；平均年龄56.1岁±9.4岁）和18例对照患者（7例男性和11例女性；52.8岁±12.3岁）。静脉注射碘佛醇（40 mL团注；每毫升含320 mg碘）后对肝脏进行单层面扫描。
与对照患者（分别为1.06和0.26）相比，两种技术均显示肝硬化患者的PVP降低（直接法为0.63，间接法为0.17），但只有直接法符合基于动物和人体研究的生理预期。在区分肝硬化患者和对照患者时，直接法的受试者工作特征曲线下面积显著更大（0.91对0.78；P = 0.03）。
直接法和间接法均可行，且能很好地区分肝硬化患者和对照患者，但直接法更符合生理情况，若有门静脉数据则更可取。
