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目的探讨优化肝硬化患者16层螺旋CT肝内门静脉成像时间。方法70例正常人与65例肝硬化患者(Child A级30例,Child B级18例,Child C级17例)分别先采用Testbolus技术测定主动脉、门静脉及肝脏实质时间密度曲线,测定主动脉、门静脉及肝实质强化峰值时间;分别记录主动脉、门静脉及肝实质强化峰值时间及CT值。统计处理采用SPSS11.0统计软件包。结果正常人主动脉强化峰值时间与肝硬化患者主动脉强化峰值时间差值之间并无统计学差异(P=0.072),二者主动脉强化峰值之差值间也无统计学差异(P=0.14)。肝硬化患者平均门静脉峰值时间(42.2 s)明显长于正常人(34.5 s,P<0.05)。肝硬化患者门静脉强化峰值(49.9 HU)明显低于正常人(58.0 HU,P<0.05)。正常人与肝硬化患者肝实质强化峰值时间分别为53.9 s和62.5 s(P<0.05),而二者肝实质强化峰值分别为26.6 HU和24.5 HU(P<0.05)。Child B、C级肝硬化患者平均门静脉强化峰值时间(43.8 s)稍长于Child A级肝硬化患者(40.5 s),但二者之间并无统计学差异(P=0.163)。结论在注射速度相同(5 ml/s)的情况下肝硬化患者门静脉强化时间(42.3 s)明显长于正常人(34.4 s),Child B、C级肝硬化患者门静脉强化峰值时间(43.9 s)稍长于Child A级肝硬化患者(40.5 s),但二者之间并无统计学差异。
Objective To investigate the optimal time of intrahepatic portal vein imaging in patients with cirrhosis by 16-slice spiral CT. Methods 70 healthy subjects and 65 cirrhotic patients (30 Child A, 18 Child B, and 17 Child C) were used to measure the real time density curve of the aorta, portal vein and liver using Testbolus technique. The aorta , Portal vein and liver parenchyma peak time; respectively, aortic, portal vein and liver parenchymal peak time and CT values were recorded. Statistical processing using SPSS11.0 statistical package. Results There was no significant difference (P = 0.072) between the peak time of aortic enhancement and the peak value of aortic enhancement in patients with cirrhosis. There was also no significant difference between the two groups (P = 0.14). The mean portal vein peak time (42.2 s) in patients with cirrhosis was significantly longer than that in normal subjects (34.5 s, P <0.05). The portal vein peak value (49.9 HU) in patients with cirrhosis was significantly lower than that in normal people (58.0 HU, P <0.05). The peak intensities of liver parenchyma in normal and cirrhosis patients were 53.9 s and 62.5 s, respectively (P <0.05), while the peak values of liver parenchyma were 26.6 HU and 24.5 HU (P <0.05). In Child B, the mean duration of portal vein enhancement (43.8 s) was slightly longer in Child C cirrhosis than in Child A cirrhosis (40.5 s), but there was no significant difference between the two groups (P = 0.163). Conclusions The portal vein enhancement time (42.3 s) in patients with cirrhosis is significantly longer than that in normal subjects (34.4 s) at the same injection speed (5 ml / s). The portal vein peak enhancement time (43.9 s) in patients with cirrhosis of Child B and C cirrhosis is slightly Longer than Child A cirrhosis (40.5 s), but there was no statistical difference between the two.