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目的探讨多层螺旋CT(MSCT)肝脏灌注成像在肝纤维化早期诊断中的应用价值。资料与方法28例接受MSCT肝脏灌注成像检查,其中6名为无明显肝脏疾病的自愿者(正常对照组),22例经肝脏穿刺活检证实为肝纤维化。根据Ishak评分系统及是否需要抗病毒治疗分为两组:10例为轻度肝纤维化患者,不需抗病毒药物治疗(轻度肝纤维化组),12例为显著肝纤维化患者,需行抗病毒治疗(显著肝纤维化组)。计算各组的各项灌注指标并进行组间比较。结果从正常对照组、轻度肝纤维化组到显著肝纤维化组,肝动脉分数(HAF)呈升高趋势,其平均HAF值分别为(17.09±3.43)%、(19.92±6.01)%和(21.32±7.47)%,平均通过时间(MTT)则有所降低,三组的MTT值分别为(13.49±1.02)s、(12.35±1.31)s和(12.19±3.33)s。正常对照组、轻度肝纤维化组和显著肝纤维化组的平均血流量(BF)值分别为(102.75±32.76)ml.100g-1.min-1、(114.54±25.81)ml.100g-1.min-1和(111.98±19.81)ml.100g-1.min-1;平均血容量(BV)值分别为(15.97±7.59)ml/100g、(17.07±2.94)ml/100g和(16.42±5.53)ml/100g。各组平均HAF、MTT、BF及BV值的差异无统计学意义(P>0.05)。结论MSCT肝脏灌注可用于各项肝脏血流灌注参数的定量测量,部分灌注参数值的变化对肝纤维化分期具有一定程度的参考价值,但目前尚不能有效地进行肝纤维化的早期诊断。
Objective To investigate the value of multi-slice spiral CT (MSCT) perfusion imaging in the early diagnosis of liver fibrosis. Materials and Methods 28 patients underwent MSCT liver perfusion imaging. Six of them were volunteers without obvious liver disease (control group), and 22 were confirmed by liver biopsy as liver fibrosis. According to Ishak scoring system and the need for antiviral therapy are divided into two groups: 10 patients with mild liver fibrosis without antiviral drugs (mild liver fibrosis group), 12 patients with significant liver fibrosis, required Antiarrhythmic (significant group of liver fibrosis). Calculate each group of perfusion index and compare between groups. Results The hepatic artery fraction (HAF) tended to increase from normal control group to mild hepatic fibrosis group to (17.09 ± 3.43)%, (19.92 ± 6.01)% and (21.32 ± 7.47)%, and the mean transit time (MTT) decreased. The MTT values of the three groups were (13.49 ± 1.02) s, (12.35 ± 1.31) s and (12.19 ± 3.33) s, respectively. The average blood flow (BF) values of the normal control group, mild hepatic fibrosis group and significant hepatic fibrosis group were (102.75 ± 32.76) ml.100g-1.min-1, (114.54 ± 25.81) ml.100g- The average blood volume (BV) values were (15.97 ± 7.59) ml / 100g, (17.07 ± 2.94) ml / 100g and (16.42 ± 5.53) ml / 100g. There was no significant difference in average HAF, MTT, BF and BV between groups (P> 0.05). Conclusion MSCT hepatic perfusion can be used for quantitative measurement of hepatic perfusion parameters. The changes of partial perfusion parameters have a certain reference value for the stage of hepatic fibrosis, but the early diagnosis of hepatic fibrosis can not be effectively performed.