苏 蕾，梁 盼，常丽阳，胡丽丽，吴 艳，高剑波

(郑州大学第一附属医院放射科，河南 郑州 450052)

能谱CT成像定量评估Budd-Chiari综合征患者肝功能

苏 蕾，梁 盼，常丽阳，胡丽丽，吴 艳，高剑波*

(郑州大学第一附属医院放射科，河南 郑州 450052)

[摘 要]目的探讨能谱CT定量参数值评估Budd-Chiari综合征(BCS)患者肝功能分级的临床价值。方法采用能谱CT对81例BCS患者行双期增强扫描，测量并计算门静脉期肝脏Ⅰ～Ⅷ段及脾脏的碘基值(IC)及标准化碘基值(NIC)，比较不同Child-Pugh肝功能等级患者(Child-Pugh A级30例，B级27例，C级24例)间NIC的差异。记录患者的凝血酶原时间(PT)、白蛋白(ALB)、总胆红素(TBIL)、谷草转氨酶(AST)和谷丙转氨酶(ALT)，分析不同肝功能等级BCS患者肝脏NIC与肝功能实验室指标间的相关性。结果不同肝功能分级患者之间，肝脏Ⅰ、Ⅲ段和脾脏的NIC总体差异有统计学意义(P=0.031、0.045、0.008)。肝功能A级患者肝脏Ⅰ、Ⅲ段的NIC高于C级(P均<0.05)，A级与B级、B级与C级间差异均无统计学意义(P均>0.05)；肝功能A级患者脾脏NIC大于B级和C级(P=0.037、0.017)，B级与C级间差异无统计学意义(P=0.073)。不同肝功能等级BCS患者肝脏NIC与PT及TBIL呈负相关(P均<0.05)，与ALB呈正相关(P均<0.05)，与ALT和AST无相关(P均>0.05)。结论能谱CT定量测量NIC有助于评估BCS患者肝功能状态。

[关键词]布加综合征；体层摄影术，X线计算机；能谱成像；血管造影术

[中图分类号]R657.34; R814.42

[文献标识码]A

[文章编号]1003-3289(2018)08-1233-04

[第一作者]苏蕾(1982—)，女，河南郑州人，博士，主治医师。研究方向：腹部影像诊断。E-mail: 878574853@qq.com

[通信作者]高剑波，郑州大学第一附属医院放射科，450052。E-mail: cjr.gaojianbo@vip.163.com

[收稿日期]2017-12-22

[修回日期]2018-04-28

SpectralCTquantitativeparametersinevaluationofliverfunctionofpatientswithBudd-Chiarisyndrome

SULei,LIANGPan,CHANGLiyang,HULili,WUYan,GAOJianbo*

(DepartmentofRadiology,theFirstAffiliatedHospitalofZhengzhouUniversity,Zhengzhou450052,China)

AbstractObjectiveTo investigate the clinical value of quantitative parameters of spectral CT in evaluating liver function of patients with Budd-Chiari syndrome (BCS).MethodsTotally 81 patients with BCS underwent dual-phase enhanced CT with spectral CT. The iodine concentration (IC) and normalized iodine concentration (NIC) were measured and calculated onⅠ—Ⅷ segments of hepatic parenchyma and spleen, then NIC was compared among patients with different degrees of liver functions (Child-Pugh A grade 30 patients, B grade 27 patients, C grade 24 patients). Prothrombin time (PT), albumin (ALB), total bilirubin (TBIL), aspartate transaminase (AST) and alanine transaminase (ALT) of these patients were recorded. The correlation between liver NIC and each clinical indicators in BCS patients with different liver function were analyzed.ResultsThere were significant differences of NIC in hepatic segments ofⅠ, Ⅲ and spleen in BCS patients with different liver functions (P=0.031, 0.045, 0.008). There was no significant difference in hepatic segments ofⅠand Ⅲ in patients with different types of BCS except between grade A and C (bothP<0.05). NIC of spleen in grade A was higher than that in grades B and C (P=0.037, 0.017), and there was no significant difference between grade B and grade C (P=0.073). NIC of liver in BCS patients with different liver functions showed negative correlation with PT and TBIL (allP<0.05) and positive correlation with ALB (allP<0.05). There was no correlation of liver NIC with ALT nor AST (allP>0.05).ConclusionThe spectral quantitative parameters of spectral CT may be helpful to evaluating liver function in patients with BCS.

[Key words]Budd-Chiari syndrome; Tomography, X-ray computed; Spectral imaging; Angiography

DOI：10.13929/j.1003-3289.201712115

Budd-Chiari综合征(Budd-Chiari syndrome， BCS)的发病机制为下腔静脉肝段/肝静脉狭窄或闭塞，肝脏血液流出道受阻，导致门静脉压力增高，可发展为慢性门静脉高压症[1-2]。BCS可引起肝脏血流灌注重新分配，导致肝功能改变，而肝功能评估在BCS的治疗及预后判断中有重要价值[3]。……