能谱CT成像定量评估Budd-Chiari综合征患者TIPS术治疗前后肝功能状态临床价值研究*

doi:10.3969/j.issn.1672-5069.2019.05.017

Abstract

Abstract: Objective The aim of this study was to explore the clinical value of quantitative assessment of liver functions by energy dispersive CT imaging in patients with Budd-Chiari syndrome before and after treatment. Methods Fifty-eight patients with BCS were enrolled to our hospital between May 2012 and April 2018,and they were classified into Child class A（n=21）,class B （n=18） and class C（n=19）. All the patients underwent transjugular intrahepatic portosystemic shunt （TIPS） and before and after the treatment,the energy spectrum CT scanning was performed. After CT scanning,the image was transmitted to the post-processing workstation. Regions of interest（ROI） was plotted in Couinaud segment I-VIII. The normalized iodine concentration at each segment of the liver before and after the treatment were calculated. Results Before TIPS,the normalized iodine concentration at segment I to VIII in patients with Child class A were（0.32±0.21）,（0.33±0.12）,（0.31±0.07）,（0.31±0.02）,（0.31±0.02）,（0.31±0.03）,（0.31±0.09） and（0.31±0.11）,all significantly greater than【（0.28±0.14）,（0.28±0.13）,（0.28±0.08）,（0.27±0.09）,（0.22±0.09）,（0.25±0.10）,（0.27±0.13） and （0.28±0.10）,respectively,P<0.05】 in patients with Child class B or【（0.21±0.10）,（0.20±0.09）,（0.19±0.07）,（0.19±0.11）,（0.19±0.12）,（0.19±0.10）,（0.20±0.11） and（0.19±0.10）,respectively,P<0.05】 in patients with Child class C;after the TIPS procedure,the normalized iodine concentration at each segment in patients with different liver function classification elevated obviously as the liver functions improved,and the normalized iodine concentration in patients with Child class A elevated greatly. Conclusion The application of energy-spectrum CT imaging has important value in quantitatively evaluating the liver functions in patients with Budd-Chiari syndrome before and after treatment. It might indirectly reflect the blood supply of liver according to the normalized iodine concentration,by which the clinicians might therefore quantitatively evaluate the curative efficacy of any treatment in patients with BCS. The materials might provide further effective information for clinical managements.

Key words: Budd-Chiari syndrome, Transjugular intrahepatic portosystemic shunt, Energy spectrum CT, Normalized iodine concentration, Therapeutic evaluation

Ba Zhengwu, Li Hailong, Yang Hui. Quantitative evaluation of hepatic function by EDCT in patients with Budd-Chiari syndrome before and after TIPS[J]. Journal of Practical Hepatology, 2019, 22(5): 680-683.

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Quantitative evaluation of hepatic function by EDCT in patients with Budd-Chiari syndrome before and after TIPS

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