Department of Radiology, Kobe University Graduate School of Medicine, 7-5-2 Kusunokicho, Chuoku, Kobe 650-0017, Japan. k
Eur J Radiol. 2012 Oct;81(10):2470-5. doi: 10.1016/j.ejrad.2011.10.009. Epub 2011 Nov 3.
To report initial experience of upper abdominal perfusion measurement with 320-detector row CT (CTP) for assessment of liver diseases and therapeutic effects.
Thirty-eight patients who were suspected of having a liver disease underwent CTP. There were two patients with liver metastases, two with hemangiomas, and four with cirrhosis (disease group). CTP was repeated for four patients with cirrhosis or hepatocellular carcinoma (HCC) after therapy. Hepatic arterial and portal perfusion (HAP and HPP) and arterial perfusion fraction (APF), and arterial perfusion (AP) of pancreas, spleen, stomach, and intra-portal HCC were calculated. For disease-free patients (normal group), the values were compared among liver segments and among pancreatic and gastric parts. The values were compared between groups and before and after therapy.
No significant differences were found in the normal group except between APFs for liver segments 3 and 5, and fundus and antrum. Mean HAP and APF for the disease group were significantly higher than for the normal group. APF increased after partial splenic embolization or creation of a transjugular intrahepatic portosystemic shunt. HPP increased and AP of intra-portal HCC decreased after successful radiotherapy.
320-Detector row CT makes it possible to conduct perfusion measurements of the whole upper abdomen. Our preliminary results suggested that estimated perfusion values have the potential to be used for evaluation of hepatic diseases and therapeutic effects.
报告使用 320 排 CT(CTP)对上腹部灌注进行测量的初步经验,以评估肝脏疾病和治疗效果。
对 38 例疑似肝脏疾病的患者进行 CTP 检查。其中包括 2 例肝转移瘤、2 例肝血管瘤和 4 例肝硬化(疾病组)。对 4 例肝硬化或肝细胞癌(HCC)患者进行 CTP 复查。计算肝动脉和门静脉灌注(HAP 和 HPP)和动脉灌注分数(APF),以及胰腺、脾脏、胃和门静脉内 HCC 的动脉灌注(AP)。对无疾病患者(正常组),比较肝段之间和胰腺、胃之间的各参数值。比较各组之间、治疗前后各参数值的差异。
除肝段 3 和 5 的肝动脉灌注分数(APF)以及胃底和胃体之间存在差异外,正常组各参数值无明显差异。疾病组的 HAP 和 APF 均值明显高于正常组。部分性脾栓塞术或经颈静脉肝内门体分流术治疗后,APF 增加。成功放疗后,门静脉内 HCC 的 HPP 增加,AP 降低。
320 排 CT 可对上腹部进行全肝灌注测量。初步结果表明,估计的灌注值具有评估肝脏疾病和治疗效果的潜力。