肝硬化PHT经颈内静脉肝内门体分流术前后的肝CT类灌注成像研究

doi:10.13418/j.issn.1001-165x.2023.2.20

摘要/Abstract

摘要： 目的探讨肝硬化门静脉高压（Portal hypertension，PHT）患者行经颈内静脉肝内门体分流术前、后肝CT类灌注成像的应用价值。方法回顾2018年1月至2020年1月我院行经颈内静脉肝内门体分流术治疗的肝硬化PHT患者62例，收集术前、术后的CT扫描图像，计算经颈内静脉肝内门体分流术前后肝动脉、门脉类灌注，分析CT灌注参数的差异；根据治疗效果分组，计算各组AEF值；收集患者术前、后的血清检查结果，并计算患者MELD评分。结果肝硬化PHT患者术后的肝动脉灌注、动脉灌注指数较术前有显著的提高（P<0.05），肝门静脉灌注术前、术后差异不大。患者术后动脉增强分数上升，和术前值具有统计学差异（P<0.05）。术后终末期肝病模型评分增加，和术前比较具有统计学差异（P<0.05）。结论肝CT类灌注成像能够反映肝硬化PHT患者行经颈内静脉肝内门体分流术前、后的肝微循环变化；行经颈内静脉肝内门体分流术不会使患者肝功能恶化好转。

关键词: 肝硬化； , , PHT； , , 经颈内静脉肝内门体分流术； , , 灌注成像

Abstract: Objective To investigate the application value of CT perfusion imaging in liver cirrhosis patients with portal hypertension (PHT) before and after transjugular intrahepatic portosystemic shunt. Methods A retrospective analysis of 62 patients with PHT of liver cirrhosis who underwent transjugular intrahepatic portosystemic shunt in our hospital from January 2018 to January 2020 was performed. The CT images before and after transjugular intrahepatic portosystemic shunt was collected. The perfusion of hepatic artery and portal vein before and after the intrahepatic portal shunt of internal jugular vein were calculated to analyze the differences of CT perfusion parameters . Then, according to the treatment effect, the AEF values of each group were calculated. The serum examination results before and after operation were collected, and the MELD score of patients was calculated. Results The HAP and HPI of patients after operation were significantly improved compared with those before operation. There was no significant difference in hepatic portal vein before and after operation. There were statistically significant differences in several perfusion parameters before and after operation (P<0.05). AEF increased after operation, and the difference was statistically significant (P<0.05).The MELD value of PHT patients with liver cirrhosis increased after operation, and the difference was statistically significant compared with that before operation (P<0.05). Conclusions Hepatic CT perfusion imaging can reflect the changes of hepatic microcirculation before and after transjugular intrahepatic portosystemic shunt in PHT patients with liver cirrhosis, and transjugular intrahepatic portosystemic shunt does not worsen the liver function.

Key words: Liver cirrhosis; , PHT; , Transjugular intrahepatic portosystemic shunt; , Perfusion imaging

中图分类号:

R575

李斯锐, 吴宁, 黄渭, 卢先明, 马明昭. 肝硬化PHT经颈内静脉肝内门体分流术前后的肝CT类灌注成像研究[J]. 中国临床解剖学杂志, 2023, 41(2): 234-239.

Li Sirui, Wu Ning, Huang Wei, Lu Xianming, Ma Mingzhao. Hepatic CT perfusion imaging of PHT in cirrhotic patients before and after transjugular intrahepatic portosystemic shunt[J]. Chinese Journal of Clinical Anatomy, 2023, 41(2): 234-239.

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