Department of Radiology, Kobe University Graduate School of Medicine, 7-5-2 Kusunokicho, Chuoku, Kobe 650-0017, Japan.
Eur J Radiol. 2012 Sep;81(9):2075-9. doi: 10.1016/j.ejrad.2011.07.003. Epub 2011 Jul 29.
To compare the efficacy of three analytic methods, maximum slope (MS), dual-input single-compartment model (CM) and deconvolution (DC), for CT measurements of hepatic perfusion and assess the effects of extra-hepatic systemic factors.
Eighty-eight patients who were suspected of having metastatic liver tumors underwent hepatic CT perfusion. The scans were performed at the hepatic hilum 7-77 s after administration of contrast material. Hepatic arterial and portal perfusions (HAP and HPP, ml/min/100 ml) and arterial perfusion fraction (APF, %) were calculated with the three methods, followed by correlation assessment. Partial correlation analysis was used to assess the effects on hepatic perfusion values by various factors such as age, sex, risk of cardiovascular diseases, arrival time of contrast material at abdominal aorta, transit time from abdominal aorta to hepatic parenchyma, and liver dysfunction.
Mean HAP of MS was significantly higher than DC. HPP of CM was significantly higher than MS and CM, and HPP of MS was significantly higher than DC. There was no significant difference in APF. HAP and APF showed significant and moderate correlations among the methods. HPP showed significant and moderate correlations between CM and DC, and poor correlation between MS and CM or DC. All methods showed weak correlations between HAP or APF and age or sex. Finally, MS showed weak correlations between HAP or HPP and arrival time or cardiovascular risks.
Hepatic perfusion values arrived at with the three methods are not interchangeable. CM and DC are less susceptible to extra-hepatic systemic factors.
比较最大斜率（MS）、双输入单室模型（CM）和去卷积（DC）三种分析方法在 CT 测量肝灌注中的疗效，并评估肝外全身因素的影响。
88 例疑似肝转移瘤的患者行肝 CT 灌注扫描。在对比剂注射后 7-77s 在肝门处进行扫描。用三种方法计算肝动脉和门静脉灌注（HAP 和 HPP，ml/min/100ml）和动脉灌注分数（APF，%），并进行相关性评估。采用偏相关分析评估年龄、性别、心血管疾病风险、对比剂到达腹主动脉时间、腹主动脉至肝实质的转运时间、肝功能障碍等因素对肝灌注值的影响。
MS 的平均 HAP 明显高于 DC。CM 的 HPP 明显高于 MS 和 DC，MS 的 HPP 明显高于 DC。APF 无显著差异。三种方法的 HAP 和 APF 相关性良好。CM 和 DC 之间的 HPP 相关性良好，MS 和 CM 或 DC 之间的相关性较差。所有方法的 HAP 或 APF 与年龄或性别均呈弱相关。最后，MS 的 HAP 或 HPP 与到达时间或心血管风险呈弱相关。
三种方法得出的肝灌注值不能互换。CM 和 DC 受肝外全身因素的影响较小。
