前列腺素E1对肝脏对比增强CT的影响：动脉门静脉造影期间的统计分析

Abe Yutaka, Murata Satoru, Tajima Hiroyuki, Hayashi Hiromitsu, Kumazaki Tatsuo

Department of Radiology, Nippon Medical School, Tokyo, Japan.

J Nippon Med Sch. 2003 Aug;70(4):307-12. doi: 10.1272/jnms.70.307.

PURPOSE

To determine the diagnostic effect of prostaglandin E(1) on contrast enhancement quality of CT during arterial portography (CTAP).

MATERIALS AND METHODS

Our patients population included 30 patients (11 women, 19 men; age range, 41 approximately 81 years) with liver tumors (23 hepatocellular carcinoma and 7 metastatic liver tumor) who had undergone angiography. We divided the 30 patients, who had undertaken CTAP twice, into two groups at random (group A; n=15, group B; n=15). In group A, first CTAP was performed without prostaglandin E(1). Approximately 5 minutes later, a second CTAP was again initiated 30 seconds after injection of prostaglandin E(1) under the same conditions. In group B, prostaglandin E(1) was injected before the first CTAP only. We measured the mean CT numbers and standard deviation (SD) numbers of anterior, posterior, medial and lateral segments in the liver at the same section of the CTAP using the same size and location of the regions of interest, and these values with and without prostaglandin E(1) were compared.

RESULTS

CT numbers: The CT numbers were significantly increased in the medial segment after the injection of prostaglandin E(1) (p<0.05) in all cases of both groups. On the other hand, they were clearly decreased in the posterior segment after the injection of prostaglandin E(1) (p<0.05) in both groups. There were no statistical differences in the CT numbers in the anterior and lateral segments in all patients. In addition, the CT numbers of anterior and posterior segments showed high attenuation compared with the medial and lateral segments in group A without prostaglandin E(1). 2) SD numbers: The SD numbers, which are an index of the homogeneous enhancement, were significantly decreased in the posterior, medial and lateral segments after the injection of prostaglandin E(1) (p<0.01, p<0.05, p<0.01, respectively) in both groups. There were no significant differences in the SD numbers in the anterior segment regardless of the injection of prostaglandin E(1) in all cases.

CONCLUSION

CTAP with injection of prostaglandin E(1) makes contrast enhancement of liver parenchyma more homogeneously than the conventional procedure, and it may be a useful technique for the detection of liver tumors.

目的

确定前列腺素E(1)对动脉门静脉造影（CTAP）期间CT增强质量的诊断效果。

材料与方法

我们的患者群体包括30例（11名女性，19名男性；年龄范围41至81岁）患有肝肿瘤（23例肝细胞癌和7例肝转移瘤）且已接受血管造影的患者。我们将这30例接受过两次CTAP的患者随机分为两组（A组；n = 15，B组；n = 15）。在A组中，首次CTAP在未使用前列腺素E(1)的情况下进行。大约5分钟后，在相同条件下，于注射前列腺素E(1)后30秒再次启动第二次CTAP。在B组中，仅在首次CTAP前注射前列腺素E(1)。我们在CTAP的同一层面使用相同大小和位置的感兴趣区域测量肝脏前、后、内侧和外侧段的平均CT值和标准差（SD）值，并比较使用和未使用前列腺素E(1)时的这些值。

结果

1）CT值：在两组所有病例中，注射前列腺素E(1)后内侧段的CT值显著升高（p < 0.05）。另一方面，两组注射前列腺素E(1)后后段的CT值明显降低（p < 0.05）。所有患者前侧段和外侧段的CT值无统计学差异。此外，在未使用前列腺素E(1)的A组中，前侧段和后侧段的CT值与内侧段和外侧段相比显示出高衰减。2）SD值：作为均匀增强指标的SD值，在两组注射前列腺素E(1)后后段、内侧段和外侧段均显著降低（分别为p < 0.01、p < 0.05、p < 0.01）。无论是否注射前列腺素E(1)，所有病例前侧段的SD值均无显著差异。