不同對比劑注射流率下多層螺旋CT 肝臟灌注值的比較
史麗靜 田建明 畢永民 田軍 李樹平 陳煒 王敏杰
【摘要】 目的 探討使用不同對比劑注射流率對測定肝臟CT 灌注值的影響。方法 60 例健
康志愿者分成3 組, 每組20 例, 分別使用4、5、7 ml / s 的注射流率進行多層螺旋CT 肝臟灌注測量, 比
較各組間灌注值。結果 4 和5 ml / s 組、5 和7 ml / s 組, 各項指標差異均無統計學意義( P > 0. 05) ; 而
4 和7 ml /s 組間, 4 ml / s 組的肝動脈灌流量( HAP) 、門靜脈灌流量( HPP) 和肝臟總灌流量( TLP) 值都
明顯高于7 ml / s 組: HAP: ( 0. 37 ±0. 16) ml·min - 1 ·ml - 1 與( 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 與( 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 與( 0. 77 ±0. 18 ) ml·min - 1 ·ml - 1 , t = 0. 277, P =
0. 001。結論 肝臟CT 灌注測量, 不同對比劑注射流率可影響灌注指標的測定, 高流率的測定結果
數值< 較低的流率。實際應用中, 要權衡灌注效果及安全性, 采用5 ml / s 的流率即可得到滿意結果。
【關鍵詞】 肝; 灌注, 局部; 體層攝影術, X 線計算機; 造影劑
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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