Sekimoto Tadashi, Maruyama Hitoshi, Kiyono Soichiro, Kondo Takayuki, Shimada Taro, Ishibashi Hiroyuki, Takahashi Masanori, Yokosuka Osamu, Yamaguchi Tadashi
Department of Gastroenterology and Nephrology, Chiba University Graduate School of Medicine, Chiba, Japan.
Department of Gastroenterology and Nephrology, Chiba University Graduate School of Medicine, Chiba, Japan.
Ultrasound Med Biol. 2014 Sep;40(9):2082-8. doi: 10.1016/j.ultrasmedbio.2014.04.014. Epub 2014 Jul 10.
The aim of the study described here was to evaluate the significance of the hepatic filling rate of a perflubutane microbubble agent in predicting long-term outcomes and prognoses in 32 patients with cirrhosis (37-76 y, 20 females, Child-Pugh A16, B16). The time from delivery of the contrast agent to the hepatic artery to maximum enhancement of the liver parenchyma on the sonogram was defined as the hepatic filling rate (mean = 18.6 s). Hepatic filling rate did not correlate significantly with the Child-Pugh score or the model for end-stage liver disease score. However, the survival rate was lower (93.3% at 1 y, 60.2% at 3 y) and the rate of occurrence of hepatocellular carcinoma (HCC) was higher (13.3% at 1 y, 33.3% at 3 y) in the group with the slow filling rate (≥18 s) than in the group with the rapid filling rate (<18 s) (93.3% at 1 and 3 y for survival, 6.3% at 1 and 3 y for HCC occurrence). Hepatic filling rate may constitute a non-invasive marker for the occurrence of HCC and prognosis of cirrhosis.
本研究的目的是评估全氟丁烷微泡剂的肝灌注率在预测32例肝硬化患者（年龄37 - 76岁，女性20例，Child-Pugh A级16例，B级16例）的长期结局和预后中的意义。从造影剂注入肝动脉到超声检查时肝实质达到最大增强的时间定义为肝灌注率（平均 = 18.6秒）。肝灌注率与Child-Pugh评分或终末期肝病模型评分无显著相关性。然而，灌注率慢（≥18秒）的组的生存率较低（1年时为93.3%，3年时为60.2%），肝细胞癌（HCC）发生率较高（1年时为13.3%，3年时为33.3%），而灌注率快（<18秒）的组1年和3年生存率均为93.3%，1年和3年HCC发生率均为6.3%。肝灌注率可能是HCC发生和肝硬化预后的一种非侵入性标志物。
