Blomley M J, Coulden R, Dawson P, Kormano M, Donlan P, Bufkin C, Lipton M J
Department of Radiology, University of Chicago Hospital, IL, USA.
J Comput Assist Tomogr. 1995 May-Jun;19(3):424-33. doi: 10.1097/00004728-199505000-00016.
Our goal was to quantify absolute hepatic arterial and portal venous perfusion noninvasively in patients with and without liver disease using ultrafast CT.
A single slice through the porta hepatis was repeatedly scanned after bolus injection of 25 ml of iohexol 300 mg I/ml, followed by a 25 ml saline "chaser" intravenously at 10 ml/s. Thirty-nine controls, 7 cirrhotic patients, and 5 patients with known metastases on the slice plane were studied; hepatic arterial perfusion was determined in 41 patients and portal venous perfusion in 24. Time-attenuation curves from regions of interest drawn over the liver, spleen, aorta, and portal vein were analysed. Hepatic arterial perfusion was calculated by dividing the peak gradient of the liver time-attenuation curve prior to the time of peak splenic attenuation by the peak aortic CT number increase. Splenic perfusion was calculated by dividing the peak gradient of the splenic time-attenuation curve by the peak aortic CT number increase. Portal perfusion was derived by scaling the splenic time-attenuation curve by the ratio of hepatic arterial/splenic perfusion. This scaled curve was subtracted from the liver time-attenuation curve to give a portal curve. The peak up-slope of this curve was divided by the peak rise in splenic or portal vein density.
Hepatic arterial perfusion averaged 0.19 ml/min/ml (n = 31) in controls and was raised in cirrhosis to 0.25 ml/min/ml (n = 6) and metastases 0.43 ml/min/ml (n = 4). Portal venous perfusion was 0.93 ml/min/ml (n = 19) in controls and 0.43 ml/min/ml (n = 4) in cirrhosis. Reproducibility has been confirmed.
Dynamic ultrafast CT shows potential in quantifying arterial and portal hepatic perfusion. The technique may be adaptable to dynamic bolus MRI.
我们的目标是使用超快CT对患有和未患有肝脏疾病的患者进行绝对肝动脉和门静脉灌注的无创定量分析。
在静脉推注25ml碘海醇300mg I/ml后，以10ml/s的速度静脉注射25ml生理盐水“追踪剂”，对肝门部进行单层重复扫描。研究了39名对照者、7名肝硬化患者和5名在扫描层面有已知转移灶的患者；对41名患者测定了肝动脉灌注，对24名患者测定了门静脉灌注。分析了在肝脏、脾脏、主动脉和门静脉上绘制的感兴趣区域的时间-衰减曲线。肝动脉灌注通过将脾脏衰减峰值出现之前肝脏时间-衰减曲线的峰值梯度除以主动脉CT值的峰值增加来计算。脾脏灌注通过将脾脏时间-衰减曲线的峰值梯度除以主动脉CT值的峰值增加来计算。门静脉灌注通过将脾脏时间-衰减曲线按肝动脉/脾脏灌注的比例进行缩放得出。从肝脏时间-衰减曲线中减去该缩放后的曲线以得到门静脉曲线。该曲线的峰值上升斜率除以脾脏或门静脉密度的峰值上升。
对照组肝动脉灌注平均为0.19ml/min/ml（n = 31），肝硬化患者中升高至0.25ml/min/ml（n = 6），转移灶患者中为0.43ml/min/ml（n = 4）。对照组门静脉灌注为0.93ml/min/ml（n = 19），肝硬化患者中为0.43ml/min/ml（n = 4）。已证实该方法具有可重复性。
动态超快CT在定量肝动脉和门静脉灌注方面显示出潜力。该技术可能适用于动态团注MRI。
