【摘要】 目的应用四维CT灌注(4D-CTP)技术研究不同比例肝切除(PH)术后大鼠残肝微循环血流动力学变化。方法将144只SD大鼠随机分入假手术(sham)组及50%、60%、70%、80%PH组,每组24只,余24只做补充实验。术后1h、1、3和7天,sham组和手术组各取6只大鼠行4D-CTP检查,计算肝动脉灌注量(HAP)、门静脉灌注量(PVP)、总肝灌注量(TLP)和肝动脉灌注指数(HPI),之后取肝脏行病理学检查。结果共21只大鼠符合小肝综合征(SFSS)表现,70%PH组1只,80%PH组20只。各PH组PVP、TLP均于术后1h达峰值,术后1天下降,术后3、7天趋于稳定;50%、60%PH组HAP、HPI术后1h、1天降低,3天和7天略增高;70%、80%PH组HAP术后1h最高,术后1、3、7天逐渐下降,HPI于术后1h显著降低,术后1天进一步轻度降低,术后3、7天稍增高。术后1h,80%PH组PVP、TLP高于50%、60%PH组和sham组(P均<0.05),HPI低于sham组(P<0.05);术后1天,80%PH组PVP、TLP高于sham组(P均<0.05),HPI低于sham组(P<0.05);术后3、7天各组PVP、TLP、HPI、HAP差异均无统计学意义(P均>0.05)。结论应用4D-CTP技术可定量分析大鼠PH术后残肝血流动力学变化,有效区分肝动脉、门静脉血流灌注异常。更多还原

【Abstract】 Objective To observe microcirculatory hemodynamic changes of remnant liver after partial hepatectomy(PH)with different proportions for rat models using four-dimensional CT perfusion(4D-CTP)technique.Methods A total of144SD rats were randomly divided into sham group,50%,60%,70%,80% PH group and supplemental group(n=24).At 1h,1day,3days and 7days after PH operation,4D-CTP scan was administrated for 6rats from each group.Hepatic artery perfusion(HAP),portal vein perfusion(PVP),total liver perfusion(TLP)and hepatic perfusion index(HPI)were calculated based on 4D-CTP raw data.Then the remnant liver was taken for histopathological analysis.ResultsSmall-for-size syndrome(SFSS)was found in 21rats,1in 70% PH group and 20in 80% PH group.In all PH groups,PVP and TLP increased and reached to the peak value 1hafter operation,descended 1day after operation,stabilized 3and7days after operation.In 50% and 60% PH group,HPI and HAP descended 1hand 1day after operation,increased 3and 7days after operation.In 70%and 80% PH group,HAP increased and reached to the peak value 1hafter operation,descended 1,3and 7days after operation,HPI descended 1hand 1day after operation,increased 3and 7days after operation.At 1hafter operation,in 80% PH group,PVP and TLP were significantly higher than those in 50% and 60% PH groups,as well as in sham group(all P<0.05),HPI was significantly lower than that in sham group(P<0.05).One day after operation,PVP and TLP in 80% PH group were still higher than those in sham group(all P<0.05),HPI was significantly lower than that in sham group(P<0.05).Three and 7days after operation,there was no significant difference of PVP,TLP,HAP,HPI among all groups(all P>0.05).Conclusion Using 4D-CTP,hemodynamic changes of microcirculatory for remnant liver rat after PH can be obtained quantatively,which can effectively distinguish hepatic artery and portal vein perfusion.更多还原