不同对比剂注射流率下多层螺旋CT 肝脏灌注值的比较

不同对比剂注射流率下多层螺旋CT 肝脏灌注值的比较
史丽静 田建明 毕永民 田军 李树平 陈炜 王敏杰
【摘要】 目的 探讨使用不同对比剂注射流率对测定肝脏CT 灌注值的影响。方法 60 例健
康志愿者分成3 组, 每组20 例, 分别使用4、5、7 ml / s 的注射流率进行多层螺旋CT 肝脏灌注测量, 比
较各组间灌注值。结果 4 和5 ml / s 组、5 和7 ml / s 组, 各项指标差异均无统计学意义( P > 0. 05) ; 而
4 和7 ml /s 组间, 4 ml / s 组的肝动脉灌流量( HAP) 、门静脉灌流量( HPP) 和肝脏总灌流量( TLP) 值都
明显高于7 ml / s 组: HAP: ( 0. 37 ±0. 16) ml·min - 1 ·ml - 1 与( 0. 26 ±0. 10 ) ml ·min - 1 ·ml - 1 , t =
0. 105, P = 0. 010; HPP: ( 0. 68 ±0. 19) ml·min - 1 ·ml - 1 与( 0. 51 ±0. 13) ml·min - 1 ·ml - 1 , t = 0. 172,
P = 0. 001; TLP: ( 1. 05 ±0. 30) ml·min - 1 ·ml - 1 与( 0. 77 ±0. 18 ) ml·min - 1 ·ml - 1 , t = 0. 277, P =
0. 001。结论 肝脏CT 灌注测量, 不同对比剂注射流率可影响灌注指标的测定, 高流率的测定结果
数值< 较低的流率。实际应用中, 要权衡灌注效果及安全性, 采用5 ml / s 的流率即可得到满意结果。
【关键词】 肝; 灌注, 局部; 体层摄影术, X 线计算机; 造影剂
Effect of differ ent inj ection r ates of contr ast medium on hepatic per fusion by using multi-slice spira l
CT SHI Li-jing* , TIAN J ian-ming, BI Yong-min, TIAN Jun, LI Shu-ping, CHEN Wei, WANG Minjie.
* Department of Radiology, Changhai Hospital, The Second Military Medical University, Sha ngha i
200433, China
【Abstra ct 】 Object ive To access the effect of different injection rates of contrast medium on hepatic
perfusion by using multi-slice spiral CT ( MSCT) . Methods Sixty volunteers underwent liver dynamic CT
scan, they were divided into three groups according to different injection rate of contrast medium ( 4 ml / s,
5 ml / s, and 7 ml / s, respectively) . Their hepatic perfusion parameters were calculated and the results were
compared between the three groups. Results There are five perfusion data: hepatic arterial perfusion
( HAP) , hepatic portal perfusion ( HPP) , total liver perfusion ( TLP) , hepatic arterial perfusion index
( HPI) , hepatic portal perfusion index ( PPI ) . There is no significant difference of all indexes when
compared 4 ml / s to 5 ml / s group, and 5 ml /s to 7 ml / s group, whereas HAP, HPP and TLP of 4 ml / s
group were significant higher than those of 7 ml / s group. HAP: ( 0. 37 ±0. 16) ml ·min - 1 ·ml - 1 vs ( 0. 26 ±
0. 10) ml·min - 1 ·ml - 1 , t = 0. 105, P = 0. 010; HPP: ( 0. 68 ±0. 19 ) ml·min - 1 ·ml - 1 vs ( 0. 51 ±
0. 13) ml·min - 1 ·ml - 1 , t = 0. 172, P = 0. 001; TLP: ( 1. 05 ±0. 30 ) ml·min - 1 ·ml - 1 vs ( 0. 77 ±
0. 18) ml·min - 1 ·ml - 1 , t = 0. 277, P = 0. 001. Conclusion When evaluate liver perfusion with MSCT,
the higher the injection rate of contrast medium, the lower the perfusion data. In clinical practice, perfusion
effect, security and condition of patient should thought over to select a proper injection rate. To this study,
5 ml / s is enough.
【Key wor ds】 Liver; Perfusion, regional; Tomography, X-ray computed; Contrast media

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