Department of Diagnostic and Interventional Radiology, University Hospital of Tübingen, Hoppe-Seyler-Straße 3, D-72076 Tübingen, Germany.
Acad Radiol. 2012 May;19(5):579-87. doi: 10.1016/j.acra.2012.01.007. Epub 2012 Feb 9.
The aim of this study was to assess splenic perfusion in patients with spleen involvement in malignant hematologic diseases and liver cirrhosis and in controls without hepatosplenic disease using volume perfusion computed tomography.
Between October 2009 and December 2011, 14 hematologic patients with known spleen involvement were recruited. An additional 17 consecutive patients without known splenic or liver disease were enrolled as controls, as well as 29 patients with liver cirrhosis and portal hypertension. A 40-second volume perfusion computed tomographic scan of the upper abdomen was performed. Analysis included measurement of splenic volume, blood flow (BF), blood volume (BV), K(trans), and mean transit time (MTT).
In lymphoma patients, mean splenic volume and perfusion parameters were as follows: splenic volume, 1125.34 mL; BF, 61.24 mL/100 mL/min; BV, 16.53 mL/100 mL; K(trans), 37.00 mL/100 mL/min; and MTT, 12.42 seconds. All perfusion values of patients with lymphoma and cirrhosis differed significantly, except for BV, compared to controls. For patients with lymphoma, significant correlations were found between splenic volume and BF (r = -0.683, P = .000), splenic volume and BV (r = -0.525, P = .002), and splenic volume and MTT (r = 0.543, P = .001). During treatment, significant correlations between the diameters of nodular lymphoma target lesions, splenic volume, and the perfusion parameters were present for splenic volume (r = 0.601, P = .002), BF (r = -0.777, P = .000) and BV (r = -0.500, P = .011).
Volume perfusion computed tomography represents a novel tool for the assessment of splenic perfusion. Preliminary results in patients with spleen involvement reveal lower perfusion values compared to controls or patients with cirrhosis. Therefore, this technique might provide additional information in clinical routine.
本研究旨在使用容积灌注 CT 评估恶性血液病伴脾脏受累和肝硬化患者以及无肝脾疾病的对照组的脾脏灌注。
2009 年 10 月至 2011 年 12 月，我们招募了 14 名已知脾脏受累的血液病患者。此外，还招募了 17 名连续的无已知脾脏或肝脏疾病的患者作为对照组，以及 29 名患有肝硬化和门静脉高压症的患者。对患者上腹部进行 40 秒容积灌注 CT 扫描。分析包括脾脏体积、血流量（BF）、血容量（BV）、K(trans)和平均通过时间（MTT）的测量。
在淋巴瘤患者中，脾脏体积和灌注参数如下：脾脏体积 1125.34 mL；BF 61.24 mL/100 mL/min；BV 16.53 mL/100 mL；K(trans) 37.00 mL/100 mL/min；MTT 12.42 秒。与对照组相比，除了 BV 之外，淋巴瘤和肝硬化患者的所有灌注值均有显著差异。对于淋巴瘤患者，脾脏体积与 BF（r = -0.683，P =.000）、脾脏体积与 BV（r = -0.525，P =.002）以及脾脏体积与 MTT（r = 0.543，P =.001）之间存在显著相关性。在治疗过程中，结节性淋巴瘤靶病变直径、脾脏体积与灌注参数之间存在显著相关性，其中脾脏体积与 BF（r = 0.601，P =.002）、BF 与 BV（r = -0.777，P =.000）和 BV（r = -0.500，P =.011）。
容积灌注 CT 是一种评估脾脏灌注的新方法。脾脏受累患者的初步结果显示，与对照组或肝硬化患者相比，其灌注值较低。因此，该技术可能在临床常规中提供额外的信息。
