Whole liver perfusion imaging by multi-slice spiral computed tomography based on Couinaud segments to evaluate the blood flow state in patients with chronic hepatitis B cirrhosis
Sun Guochao
Liu Hongxia
Yang Shuzheng
Han Lulu
Zhang Xihai
Zhang Bei
Abstract：Objective To explore the value of whole liver perfusion imaging by multi-slice spiral computed tomography (MSCT) based on Couinaud segments to evaluate the blood flow state in patients with chronic hepatitis B cirrhosis.Methods Totally 50 patients with chronic hepatitis B cirrhosis from January 2013 to January 2014 were selected as observation group, according to Child-pugh grading, the patients were divided into grade A (23 cases) , grade B (20 cases) and grade C (7 cases);in addition, 50 healthy volunteers with normal liver were set as control group.The MCST whole liver perfusion imaging based on Couinaud segments was performed, the perfusion parameters were measured and compared among groups.Results The peak time in observation group was significantly longer than that in control group [aorta: (15 ± 4) s vs (14 ± 3) s, portal vein: (36 ± 8) s vs (29 ± 5) s, spleen: (27 ± 6) s vs (23 ± 5) s];the peak enhancement in observation group was significantly lower than that in control group [aorta: (266 ±54) HU vs (272 ±53) HU, portal vein: (81 ±31) HU vs (91 ±34) HU, spleen: (35 ±15) HU vs (51 ±23) HU] (P＜0.05).In observation group, the perfusion parameter of each Couinaud(s) segment was not the same and the portal venous perfusion, total hepatic perfusion and hepatic perfusion index were significantly different (P ＜ 0.05);at S Ⅲ and SV segment, the hepatic arterial perfusion per 100 ml was significantly different [(11 ± 5) ml/min vs (10 ± 5) ml/min] (P ＜ 0.05).The hepatic portal vein perfusion and whole liver perfusion were significantly lower in cirrhosis patients with Chfld-Pugh grade of A, B, C than those in control group [portal vein perfusion : caudate lobe (58.3 ± 31.2), (68.7 ± 21.0), (58.9 ±30.7) ml/min vs (92.7 ±44.7) ml/min;left lateral (57.6 ±21.0), (68.3 ±20.8), (58.5 ±23.8) ml/min vs (87.0±34.4) ml/min;left lobe (63.5 ±23.2), (73.2 ±22.1), (62.1 ±31.8)ml/min vs (84.2 ±27.3) ml/min;right anterior lobe (69.5 ± 28.5), (70.7 ± 28.4), (70.5 ± 27.5) ml/min vs (91.8 ± 24.1) ml/min;right posterior leaf(56.5 ± 16.8), (68.1 ± 25.8), (57.9 ± t5.8) ml/min vs (91.6 ± 23.6) ml/min;whole liver perfusion: caudate lobe (68.3 ±21.2) , (78.7 ±31.0), (68.9 ± 30.7) ml/min vs (102.7 ±43.7) ml/min;left lateral(67.6 ±21.0), (78.3 ±25.8), (68.5 ±30.8)ml/min vs (104.0 ±34.4) ml/min;left lobe(63.5 ±23.2), (68.2 ± 22.1), (72.1 ± 38.8) ml/min vs (94.2 ± 27.3) ml/min;right anterior lobe (69.5 ± 28.5),(70.7 ±28.0), (70.5 ±27.5)ml/min vs (98.8 ±34.1) ml/min;right posterior leaf(66.5 ±26.8), (68.1 ±25.8), (77.9 ±35.8) ml/min vs (101.6±34.6) ml/min] (all P ＜0.05);there was no statistical significance in hepatic artery perfusion among groups (P ＞ 0.05).Conclusions Based on Couinaud segments, the liver blood flow of different segment was not the same;whole liver perfusion imaging by MSCT can reflect the change of blood flow of Couinaud segment, which is helpful to evaluate blood flow state of liver cirrhosis.
Keywords：Chronic hepatitis B cirrhosisCouinaud segmentsMulti-slice spiral computed tomographywhole liver perfusionBlood flow condition
Publication Date：2015-01-01
Online Publishing Date：2026-09-14(First online date of this platform, not the publication date of the document)
Pages：5( 1767-1771 )