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《Radiologic Practice》 2018-01
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Feasibility of five-phase-contrast-enhanced CT scanning in the evaluation of normal hepatic and cirrhotic perfusion charactistics

LI Qing;XIE Shuang-shuang;HOU Wen-jing;Department of Radiology Tianjin First Center Hospital;  
Objective:To investigate the feasibility and the accuracy of five-phase-contrast-enhanced CT scanning in the evaluation of perfusion characteristics in normal hepatic and cirrhotic parenchyma.Methods:16 subjects with normal liver or with solitary hepatic hemangioma(d2 cm)and 10 patients with hepatic cirrhosis were recruited in this study.All of them undertook abdominal unenhanced and five-phase-contrast-enhanced CT scanning,including early arterial,arterial,early portal venous,portal venous and delayed phases.The hepatic perfusion CT data of another 12 subjects with normal liver or solitary hepatic hemangioma(d2 cm)were recruited retrospectively for analysis.All of these hepatic perfusion parameters in 5 phase-contrast-enhanced CT were measured by 2 observers independently.The perfusion parameters,including hepatic arterial perfusion(HAP),portal vein perfusion(PVP),hepatic perfusion index(HPI),blood flow(BF)and blood volume(B were also recorded).The intraclass correlation coefficient(ICC)was used to assess interobserver agreement for hepatic perfusion parameters measurement.Student t-test was used to compare these hepatic perfusion parameters of normal hepatic parenchyma from above two methods and those of normal hepatic parenchyma and cirrhosis from five-phase-contrast-enhanced CT,as well as to compare CTDI of five-phasecontrast-enhanced CT and routine perfusion CT scan.Results:The consensus of interobserver measurement of these perfusion parameters was in good agreement(ICC:0.818~0.996).No significant difference was existed in HPI,HAP,PVP and BF of normal hepatic parenchyma obtained from five-phasecontrast-enhanced CT and cinventional perfusion CT(P=0.475,0.219,0.073,0.108 respectively),but BV obtained from the two methods was significantly different(P0.001).In five-phase-contrastenhanced CT scan,HPI,HAP obtained from cirrhosis were higher than those obtained from normal hepatic parenchyma,but PVP was lower than that from normal hepatic parenchyma,with significant differences(P0.001,0.042,0.002 respectively).BV and BF obtained from the two groups were not significantly different(P=0.488,0.093 respectively).CTDIvol of unenhanced and five-phase-contrast-enhanced CT and routine perfusion CT were(53.78±13.67)mGy,45.45 mGy respectively,with significant difference(P=0.005).CTDIvol of one-phase enhanced CT wass(8.96±2.28)mGy,accounting for 19.7% of that of conventional perfusion CT.Conclusion:Perfusion characteristics obtained from five-phase-contrast-enhanced CT is in accordance with that from conventional perfusion CT scanning,and five-phase-contrast-enhanced CT scan is potential to evaluate hepatic perfusion change of cirrhosis.
【Fund】: 国家自然科学基金(81671657);; 天津市卫生计生委科技基金(15KG133)
【CateGory Index】: R575.2;R816.5
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