Application of multi-slice spiral CT perfusion imaging in the differential diagnosis of liver fibrosis and cirrhosis
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摘要: [目的]探讨多排螺旋CT灌注成像在肝纤维化和肝硬化鉴别诊断中的应用。[方法]选择2014年1月~2016年1月在我院接受多排螺旋CT灌注成像检查的114例患者，其中肝纤维化S1~S2期40例，S3~S4期38例，肝硬化36例。选择非肝脏疾病的40例志愿者作为对照组进行多排螺旋CT灌注成像检查，比较HAP、PVP、TLP、HBF、HPI、TTP及BV。[结果]除纤维化组HAP与对照组比较差异无统计学意义外，纤维化组、肝硬化组PVP、TLP、HBF、BV灌注参数均显著低于对照组，HAP、HPI、TTP灌注参数均显著高于对照组，且纤维化组与肝硬化组各项灌注指标参数比较，差异有统计学意义（P<0.05）。HAP在肝硬化组中显著高于纤维化S1~S2期、S3~S4期患者，比较差异有统计学意义（P<0.05），但S1~S2期、S3~S4期患者间比较差异无统计学意义（P>0.05）；PVP、TLP、HBF、BV灌注参数随着患者病情的加重，各值也随之降低，S1~S2期、S3~S4期患者与肝硬化组比较，差异均有统计学意义（P<0.05）；HAP、HPI、TTP灌注参数随着患者病情的加重各值随之升高，S1~S2期、S3~S4期患者与肝硬化组比较，差异均有统计学意义（P<0.05）；并且S1~S2期患者PVP、TLP、HBF、HPI、TTP、BV与S3~S4期患者比较差异均有统计学意义（P<0.05）。[结论]多排螺旋CT灌注成像能够获得肝脏形态、功能的信息，准确地反映肝脏双重供血情况，在肝纤维化和肝硬化鉴别诊断中PVP、TLP、HBF、HPI、TTP、BV灌注参数在肝纤维化、肝硬化不同阶段的明显变化，为肝纤维化和肝硬化鉴别诊断提供了依据，具有较大参考价值。
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关键词:
- 多排螺旋CT灌注成像 /
- 肝纤维化 /
- 肝硬化 /
- 鉴别诊断
Abstract: [Objective] To investigate the multi-slice spiral CT perfusion imaging in the differential diagnosis of liver fibrosis and cirrhosis.[Methods] One hundred and fourteen cases of patients with multi-slice spiral CT perfusion imaging from January 2014 to January 2016 in our hospital were selected, 40 patients with liver fibrosis in S1~S2, 38 in S3~S4, and 36 patients with liver cirrhosis.40 volunteers without liver disease were selected as control group, and they all received multi-slice spiral CT perfusion imaging.HAP, PVP, TLP, HBF, HPI, TTP and BV of all groups were compared.[Results] There was no significant difference in HAP between liver fibrosis group and control group.PVP, TLP, HBF, BV perfusion parameters in fibrosis group and liver cirrhosis group were significantly lower than those in the control group, while HAP, HPI, TTP perfusion parameters were significantly higher than those in control group.There was statistically significant difference in perfusion parameters between fibrosis group and liver cirrhosis group(P<0.05).The perfusion parameters of HAP, HPI and TTP were significantly higher than those in control group.HAP in the cirrhosis group was significantly higher than that in S1~S2 fibrosis and S3~S4 patients(P<0.05), but there was no significant difference between the S1~S2 and S3~S4 patients(P>0.05).The value of PVP, TLP, HBF, BV perfusion parameters decreased with the aggravation of the patient's condition, and there was significant difference between S1~S2, S3~S4 patients and liver cirrhosis group(P<0.05).The value of HAP, HPI, TTP perfusion parameters increased with the aggravation of the patient's condition, and there was significant difference between S1~S2, S3~S4 patients and liver cirrhosis group(P<0.05);and there was significant difference in PVP, TLP, HBF, HPI, TTP, BV between S1~S2 and S3~S4 patients(P<0.05).[Conclusion] Multi-slice spiral CT perfusion imaging can obtain liver morphology, functional information, accurately reflect hepatic dual blood supply.The significant changes in hepatic perfusion parameter PVP, TLP, HBF, HPI, TTP, BV in liver fibrosis and different stages of liver has great reference value in the differential diagnosis of liver fibrosis and cirrhosis. -
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