Xie Peiyi, Quan Li, Xie Sidong, Chen Binghui, Wei Kaikai, Ren Jie, Meng Xiaochun
1 Department of Radiology, The Sixth Affiliated Hospital of Sun Yat-sen University , Guangzhou , China.
2 Department of Radiology, The Third Affiliated Hospital of Sun Yat-sen University , Guangzhou , China.
Br J Radiol. 2019 Jun;92(1098):20180847. doi: 10.1259/bjr.20180847. Epub 2019 Apr 24.
The microcirculatory hemodynamic changes of small-for-size syndrome (SFSS) are still unclear. In this study, they were investigated by four-dimensional CT perfusion (4D-CTP) technique.
The sham group, 50, 60, 70 and 80 % partial hepatectomy (PH) rat groups were established. At 1 hour (1 h), 1 day (1 d), 3 days (3 d) and 7 days (7 d) post-operation, serological examination, 4D-CTP scan and histopathological examination were performed. One-way analysis of variance and the Kruskal-Wallis test were used for the comparison.
Based on the diagnostic criteria of SFSS, the 80 % group was considered to be a successful model. In all the PH groups, portal vein perfusion and total liver perfusion peaked at 1 h and declined at 1d and 3d. Both portal vein perfusion and total liver perfusion were significantly higher in the 80 % group than the sham group, 50 and 60% groups at 1 h ( < 0.05), and 80 % group at 3d and 7d ( < 0.05). In the 50 and 60 % groups, hepatic artery perfusion decreased at 1 h and maintained at a lower level until at 7 d; whereas, in the 70 and 80% groups, it increased at 1 h, then decreased and reached the lowest level at 7 d. No significant difference appeared in hepatic artery perfusion between any two groups at any time points. At all time points, hepatic perfusion index was lower in all the PH groups than the sham group. Significant differences in hepatic perfusion index appeared between the 80% group and the sham group at 1 h and 1 d ( < 0.05).
The CTP parameters quantitatively revealed the microcirculatory hemodynamic changes in SFSS, which were further confirmed to be associated with histopathological injury. It is suggested that the hemodynamic changes in SFSS remnant liver can provide useful information for further revealing the mechanism of SFSS and may help for guiding the treatments.
By using the 4D-CTP technique, the hepatic microcirculatory hemodynamic changes could be quantitatively measured for small animal research.
小体积综合征（SFSS）的微循环血流动力学变化仍不清楚。本研究采用四维CT灌注（4D-CTP）技术对其进行研究。
建立假手术组、50%、60%、70%和80%部分肝切除术（PH）大鼠组。术后1小时（1h）、1天（1d）、3天（3d）和7天（7d）进行血清学检查、4D-CTP扫描和组织病理学检查。采用单因素方差分析和Kruskal-Wallis检验进行比较。
根据SFSS的诊断标准，80%组被认为是成功的模型。在所有PH组中，门静脉灌注和全肝灌注在1h达到峰值，在1d和3d下降。80%组门静脉灌注和全肝灌注在1h时均显著高于假手术组、50%和60%组（P<0.05），在3d和7d时显著高于80%组（P<0.05）。在50%和60%组中，肝动脉灌注在1h时下降并维持在较低水平直至7d；而在70%和80%组中，肝动脉灌注在1h时升高，然后下降并在7d时达到最低水平。在任何时间点，两组之间肝动脉灌注均无显著差异。在所有时间点，所有PH组的肝灌注指数均低于假手术组。80%组与假手术组在1h和1d时肝灌注指数有显著差异（P<0.05）。
结论：CTP参数定量揭示了SFSS的微循环血流动力学变化，进一步证实其与组织病理学损伤有关。提示SFSS残余肝的血流动力学变化可为进一步揭示SFSS的机制提供有用信息，并可能有助于指导治疗。
通过使用4D-CTP技术，可以对小动物研究中的肝脏微循环血流动力学变化进行定量测量。
