摘要
目的探讨肝脏CT血流灌注与肝纤维化血清指标联合检测肝纤维化和早期肝硬化的诊断价值。方法分别对30例肝纤维化患者、7例肝硬化患者和18例正常对照组行GE Lightspeed 64排螺旋CT肝脏灌注扫描,用GE AW 4.4肝脏灌注分析软件取得不同病变阶段肝实质的灌注参数,包括肝血流量（BF）、肝血容积（BV）、肝动脉血流（HAF）、平均通过时间（MTT）、表面通透性（PS）,同时用免疫荧光法检测各组别肝纤维化血清学指标,包括血清Ⅲ型前胶原肽（type III）、透明质酸（HA）、层粘蛋白（LN）、Ⅳ型胶原（CIV）,并与病理改变作对照研究和统计分析。结果肝脏纤维化灌注血流参数在正常对照组和肝纤维化各组间存在显著性差异,正常对照组、肝纤维化组、肝硬化组BF、PS和HAF逐渐升高,肝硬化组BV减少,MTT缩短,血清学指标中HA在肝纤维化S1期即明显升高,LN、IV型胶原在肝纤维化S2~S4期明显升高。结论肝CT血流灌注参数结合血清标志物可对早期肝纤维化做出无创性诊断,具有临床应用价值。
Objective To evaluate the diagnostic value of hepatic perfusion with multi-slice spiral CT and several serum markers in the liver fibrosis and earlier cirrhosis.Methods Dynamic spiral CT perfusion of the liver were abtained in 30 patients with liver fibrosis,7 patients with cirrhosis and 18 control subjects.Perfusion parameter in different disease groups including hepatic blood flow（BF）,blood volume（BV）,hepatic arterial fraction（HAF）,mean transit time（MTT）,permeability surface（PS） were analyzed by liver perfusion software.Meanwhile,the serum fibrosis markers including procollagen peptide（type III）,hyaluronic（HA）,laminin（LN）,collagen IV（CIV） were made and compared in different groups proved by pathology,statistic analysis was done.Results Liver CT perfusion parameters had significant differences in control and different fibrosis groups,BF,PS and HAF were increasing among control group,liver fibrosis group and cirrhosis group,while BV was decreasing and MTT shortened.Among serum fibrosis markers,HA was significant increasing in S1 group while LN and collagen IV were increasing in S2-4 groups.Conclusion CT perfusion parameters cooperate with serum fibrosis markers may be of help in diagnosing liver fibrosis and earlier cirrhosis noninvasively,which is valuable clinically.
出处
《上海医学影像》
2011年第1期20-23,共4页
Shanghai Medical Imaging
基金
上海市浦东新区卫生局青年基金(项目编号:PW2007B-1)
