| Objectives:By 256-slice CT perfusion imaging, to explor normal liver, hepatic B cirrhosis, biliary cirrhosis, vascular hemodynamic changes of cirrhosis of the liver and research different causes of cirrhosis on liver perfusion index.Materials and methods:Retrospective analysis of 16 cases of normal control group,27 cases of hepatitis B cirrhosis, Biliary cirrhosis in 20 cases, Vascular cirrhosis in 12 cases(Hepatic inferior vena cava stenosis in 5 cases, hepatic vein occlusion in 6 cases,1 case of mixed), underwent 256-slice CT scan whole liver perfusion. The original image introduced into Philips Brillance iCT workstation EBW (Extended Brilliance Workspace), were analyzed by Functional CT Software, calculated by using the maximum slope method. First, at the trunk level of the portal vein, ROIs were drawn in the aorta, the portal vein, the spleen and liver. Software automatically outputted the time-density-curve(TDC) and time to peak(TTP) of ROIs. Abdominal aorta acted as input artery of liver and portal vein acted as input liver vein. Second, to draw respectively hepatic left lateral lobe, left medial, right anterior lobe and right posterior lobe of liver in the better level of show of each leaf, obtain and record their hepatic arterial perfusion(HAP), portal venous perfusion(PVP), total liver perfusion(TLP), hepatic arterial perfusion index, HPI. Each lobe of the liver was mearsured 3 times, taking 12 ROIs average as the ultimately perfusion results of whole-liver. Compare the normal control group with hepatitis B cirrhosis group, biliary cirrhosis group, vascular cirrhosis group and three abnormal groups, pair wise compare every two groups of them and found the changes of TTP and liver liver blood perfusion parameter; Compare hepatic inferior vena cava stenosis and hepatic vein occlusion Budd-Chiari syndrome to changes of liver perfusion parameters in vascular cirrhosis group.Results:1. Hepatitis B cirrhosis group abdominal aorta, portal vein, spleen and liver of TTP was prolonged than normal, except for abdominal aortic TTP was not statistically significant (P>0.05), the other three TTP has significant difference (P <0.05); 2. Biliary cirrhosis abdominal aorta TTP shorter than the normal group, the portal vein, spleen, liver TTP was prolonged than normal, in addition to the abdominal aorta and liver of TTP were no statistical difference (P>0.05), the other two TTP has a statistically significant difference (P<0.05); 3. Vascular cirrhosis group of abdominal aorta, portal vein, spleen and liver of TTP were no statistical difference (P>0.05); 4. Hepatitis B cirrhosis group and Biliary cirrhosis group of abdominal aorta, portal vein, spleen and liver of TTP were no statistical difference (P>0.05); 5.Hepatitis B cirrhosis group of abdominal aorta, portal vein, spleen and liver of TTP to extend in the vascular liver cirrhosis group, in addition to the abdominal aorta, liver TTP has no statistical significance (P>0.05), the other two TTP was statistically significant (P<0.05); 6.Biliary cirrhosis group of portal vein, spleen TTP to extend in the vascular liver cirrhosis group, abdominal aorta, liver TTP is shortened vascular liver cirrhosis group, in addition to the abdominal aorta, liver TTP has no statistical significance (P>0.05), the other two TTP was statistically significant (P<0.05); 7. In Hepatitis B group, HAP, PVP and TLP declined, while the HPI raised, which were statistically significant (P<0.05); 8. In Biliary cirrhosis group, HAP declined with no statistical significance (P>0.05); PVP, TLP decline while HPI rised which were statistically significant (P<0.05); 9. In Vascular liver cirrhosis group, HAP and HPI rised without any statistical significance (P>0.05); PVP, TLP decreased with statistical significance (P<0.05); 10. In Hepatitis B cirrhosis group, HAP, PVP, TLP and HPI were all declined compared with Biliary cirrhosis group and which had no statistical significance (P>0.05); 11. In Biliary cirrhosis group, HAP, HPI increased compared with vascular cirrhosis, PVP, TLP declined and which had no statistical significance (P>0.05); 12. In Hepatitis B cirrhosis group, HAP, TLP declined while HPI rised compared with vascular cirrhosis, which was not statistically significant (P>0.05); while PVP decreased compared vascular cirrhosis, which were statistically significant (P<0.05); 13. HAP and HPI of Hepatic segment inferior vena cava stenosis Budd-Chiari syndrome rose comparing with hepatic veno-occlusive Budd-Chiari syndrome, which had significant difference. (P<0.05); PVP and TLP declined, which was not statistically significant (P>0.05).Conclusions:1. Liver perfusion imaging of 256-slice CT is simple and can reflect the hepatic hemodynamic changes of normal liver, hepatitis B cirrhosis, Biliary cirrhosis and Vascular cirrhosis. The changes of PVP, TLP are helpful for diagnosis of liver cirrhosis be used as one of the ameans of follow-up imaging.2. TTP and liver perfusion of Hepatitis B cirrhosis and biliary cirrhosis are no difference, one the contrary compared both with vascular cirrhosis show a significant difference, There is no a specific index to distinguish three types. Description CT perfusion imaging of liver cirrhosis diagnosis of type is not specific.3. Hepatic segment inferior vena cava stenosis Budd-Chiari syndrome HAP, HPI increase more than hepatic veno-occlusive Budd-Chiari syndrome... |
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