HIV合并HCV感染者早期肝硬化的肝脏CT灌注成像

目的探讨肝脏CT灌注成像对HIV合并HCV感染者早期肝硬化诊断的应用价值。方法对33例HIV感染并慢性丙型肝炎患者行肝脏CT灌注扫描,其中早期肝硬化组14例、非肝硬化组19例;对两组的各项灌注参数进行对比分析。结果早期肝硬化组与非肝硬化组对比,门静脉灌注量(HPP)、门静脉灌注指数(PPI)、肝脏总灌量(TLP)明显降低[HPP:(86.34±20.73)ml·min-1·100ml-1与(111.87±20.59)ml·min-1·100ml-1,P=0.0014;PPI:(72.18±2.94)%与(78.69±2.29)%,P=0.0001;TLP:(119.44±27.17)ml·min-1·100ml-1与(142.02±24.70)ml·min-1·100ml-1,P=0.0001],而肝动脉灌注指数(HPI)明显升高[(27.82±2.94)%与(21.31±2.29)%,P=0.0001];以上4项灌注参数在两组间的差异有统计学意义。结论肝脏CT灌注成像能反应HIV合并HCV早期肝硬化的血流灌注改变,对临床的早期诊断和治疗有重要价值。

The CT Perfusion Imaging of Liver in Patients with Early Cirrhosis with HIV/HCV Co-infected

Objective To evaluate the value of CT perfusion imaging of liver in diagnosis of the early cirrhosis in patients with HIV/HCV co-infected. Methods The CT perfusion scans of liver were tested for 33 patients with chronic hepatitis C and HIV-infected,including 14 patients with early cirrhosis and 19 patients with non-cirrhosis;parameters of the CT perfusion were compared wih two groups. Results Compared to non-cirrhosis group,HPP、PPI and TLP with patients in early cirrhosis were significant lower[HPP： （86.34±20.73）ml·min-1·100ml-1 vs （111.87±20.59） ml·min-1·100ml-1,P=0.0014; PPI：（72.18±2.94）% vs （78.69±2.29）%,P=0.0001;TLP：（ 119.44±27.17）ml·min-1·100ml-1 vs （142.02±24.70）ml·min-1·100ml-1,P=0.0185], whereas their HPI were significant higher[（27.82±2.94）%vs （21.31±2.29）%,P=0.0001]. There was significant difference of the four parameters of the CT perfusion between early cirrhosis and non-cirrhosis. Conclusion The CT perfusion of liver could reflect the variation of blood flow in the patients with early cirrhosis which was co-infected with HIV/HCV.Furthermore it could be detected for early clinical diagnosis and treatment.