Study On Classification Of Hepatocirrhosis Degree And Evaluation Of Functional Hepatic Reserve In Patients With Hepatocellular Carcinoma With The MSCT Perfusion

Object:To study the hepatic multislice CT(MSCT)perfusion parameters features in patients of hepatocirrhosis with hepatocellular carcinoma,the values of CT perfusion in classification of hepatocirrhosis degree and evaluation of functional hepatic reserve.Methods:32 patients of hepatocirrhosis with hepatocellular carcinoma were collected from June,2005 to December,2006(27men,5women,age range,28-64years,mean age,46years).First,32 patients of hepatocirrhosis with hepatocellular carcinoma were classified into three groups by CT morphologic classification:17 were classified as light hepatocirrhosis group,8 as moderate group,7 as severe group.Second,All the patients were performed hepatic MSCT perfusion examination on 8 multi slice spiral computer tomography(GE Lightspeed Ultra).On transverse scout images of the upper abdomen,a level wan determined at which the liver,aorta,and portal vein were clearly visualized.A nonionic iodinated contrast agent containing 30g I/100ml was administered Ivthrough a 19G or 20G catheter at the start of the CT study. 50ml of the contrast agent,was injected with a power injector at a rate of 4.5ml/s via an antecubital vein.The subjects kept breathing quietly during the perfusion study.To avoid respiratory motion artifacts,the subjects were clearly informed of a poddible flushing sensation during contrast agent injection.The CT perfusion protocol comprised 280 scans that were obtained at the level with the following parameters:120KV,100MA,large field of view,5-mm slice thickness.The images were transferred to GE AW4.2 workstasion for data analysis.Two regions of interest(ROIs)were drawn in the aorta and the portal vein.Three large ROIs were drawn in the right,left liver lobers.The cine full and axial full CT scan using perfusion 3 software package with deconvolution algorithm to obtain a series of perfusion parameters.Finally,We study the difference of perfusion parameters in three groups,and the correlation of the CT morphologic classification of hepatocirrhosis with Child-Pugh functional classification.Results:(1)There was significant statistical difference in BF,BV and HAF among gruops.(2)The CT morphologic classification of hepatocirrhosis degree correlated positively with Child-Pugh classification.Conclusions:(1)The parameters of hepatic MSCT perfusion can be regarded as an important imaging indexes to evaluate the hepatocirrhosis degree and functional hepatic reserve of patients with hepatocellular carcinoma.(2)CT perfusion technology is valuable and feasible to evaluate hepatocirrhosis degree.