【摘要】 目的通过检测单位体积的脾灌注量,观察肝硬化时脾脏血流量的变化及其与门静脉灌注量的关系。方法 19例经临床及实验室、B超检查诊断为肝硬化的患者,其中Child A级患者8例,Child B级患者7例,Child C级患者4例。对照组为13例无肝脏疾病的患者。所有患者均选取同时含有肝脏、脾脏、主动脉和门静脉的层面行单层CT动态增强扫描,绘制ROI时间-密度曲线计算脾脏灌注量和肝脏门脉血流量。结果正常组脾脏灌注量为1.1542±0.1408ml(min·ml),肝硬化组脾脏灌注量为1.0172±0.3137ml(min·ml),其中Child A级肝硬化组脾脏灌注量为1.2272±0.2574ml(min·ml),Child B级肝硬化组脾脏灌注量为1.0016±0.4450ml(min·ml),Child C级肝硬化组脾脏灌注量为0.6240±0.0672ml(min·ml)。严重肝硬化患者脾脏血流灌注量明显下降。门静脉灌注量和脾脏灌注量呈正相关(r=0.3023,P=0.02,y=0.3998x+0.4256)。结论螺旋CT灌注成像CT可定量测量脾脏血流量参数,肝硬化时脾脏灌注量的测定有助于反映肝硬化时门静脉灌注的变化。更多还原

【Abstract】 Objective To estimate splenic perfusion with helical CT and to study the relationship between splenic perfusion and portal vein perfusion in liver cirrhosis.Methods Dynamic single-section computed tomography(CT) of liver and spleen was performed on 32 subjects,including 19patients with liver cirrhosis and 13 patients without liver disease as control.CT scans were obtained at a single level to include the liver,spleen,aorta and portal vein.On each CT scan,the attenuation of these organs was measured in regions of interest to provide time-density curves.The splenic perfusion and portal vein perfusion of the liver were assessed.Results Splenic perfusion was 1.1542±0. 1408 mL/min/mL in control subjects and 1.0172±0.3137 mL/min/mL in patients with liver cirrhosis(1.2272±0.2574 mL/min/mL in Child A cirrhotic patients,1.0016±0.4450 mL/min/mL in Child B cirrhotic patients,0.6240±0.0672 mL/min/mL in Child C cirrhotic patients).Portal vein perfusion of the liver was positively correlated to the splenic perfusion(r=0.3023,P=0.02,y = 0.3998x + 0.4256).Conclusion Dynamic single-section CT shows potential in quantifying splenic perfusion.Splenic perfusion reflects portal vein perfusion in liver cirrhosis.更多还原