Sun Hongzan, Lu Zaiming, Liang Hongyuan, Xin Jun, Gao Yuying, Guo Qiyong
Department of Radiology, Shengjing Hospital of China Medical University Shenyang 110004, China.
Int J Clin Exp Pathol. 2014 Oct 15;7(11):8082-6. eCollection 2014.
To investigate the changes and contributions of superior mesenteric venous perfusion (SMVP) and splenic venous perfusion (SpVP) to portal venous CT perfusion in canine model of hepatic diffuse disease.
By selective catheterization in superior mesenteric and splenic arteries respectively after CT perfusion scanning, SMVP and SpVP became available. Sixteen dogs were adopted and induced by carbon tetrachloride after data under normal conditions were collected. After 3, 6, 9 and 12 months from carbon tetrachloride intervention, liver biopsies by puncture or operation were performed after CT perfusion scanning. SMVP and SpVP under different pathologic conditions were compared and analyzed.
Three stages of hepatic diffuse lesions were defined according to pathologic changes, namely hepatitis, hepatic fibrosis, and cirrhosis. The number of dogs which survived from each stage was: 16 from normal, 12 from hepatitis, 10 from hepatic fibrosis and 4 from cirrhosis. During this progressive period, SpVP ml/(min·100 ml) declined slightly, but there were no significant differences between different stages (P > 0.05). SMVP ml/(min·100 ml) in stage of normal (64.1 ± 8.1) and hepatic fibrosis (44.4 ± 4.5), normal and cirrhosis (42.6 ± 5.4), hepatitis (61.3 ± 6.4) and hepatic fibrosis, hepatitis and cirrhosis was significantly different, but there was no significant difference of SMVP between normal and hepatitis (P = 0.326) or hepatic fibrosis and cirrhosis (P = 0.668).
With our evidence of interventional CT perfusion, it is mesenteric, not splenic, perfusion that might coincide with hepatic portal venous perfusion during the progressive period of hepatic diffuse disease.
在犬肝弥漫性疾病模型中,研究肠系膜上静脉灌注(SMVP)和脾静脉灌注(SpVP)对门静脉CT灌注的变化及贡献。
在CT灌注扫描后分别经选择性插管至肠系膜上动脉和脾动脉,获得SMVP和SpVP。选取16只犬,在收集正常状态下的数据后,用四氯化碳诱导。在四氯化碳干预后3、6、9和12个月,进行CT灌注扫描后,通过穿刺或手术进行肝脏活检。比较并分析不同病理状态下的SMVP和SpVP。
根据病理变化确定肝弥漫性病变的三个阶段,即肝炎、肝纤维化和肝硬化。各阶段存活犬的数量分别为:正常16只、肝炎12只、肝纤维化10只、肝硬化4只。在此进展期,SpVP[ml/(min·100 ml)]略有下降,但不同阶段之间无显著差异(P>0.05)。正常阶段(64.1±8.1)与肝纤维化阶段(44.4±4.5)、正常与肝硬化阶段(42.6±5.4)、肝炎阶段(61.3±6.4)与肝纤维化阶段、肝炎与肝硬化阶段的SMVP[ml/(min·100 ml)]有显著差异,但正常与肝炎阶段(P = 0.326)或肝纤维化与肝硬化阶段(P = 0.668)的SMVP无显著差异。
基于我们介入性CT灌注的证据,在肝弥漫性疾病进展期,与肝门静脉灌注相符的可能是肠系膜灌注而非脾灌注。