使用动态CT评估脾灌注和脾脏大小：评估肝纤维化程度的有用

StephenW

Hepatol Res. 2017 Apr 1. doi: 10.1111/hepr.12900. [Epub ahead of print]
Evaluation of splenic perfusion and spleen size using dynamic-CT: usefulness in assessing degree of liver fibrosis.
Suzuki T1, Yamada A1, Komatsu D1, Kurozumi M1, Fujinaga Y1, Ueda K2, Miyagawa S3, Kadoya M1.
Author information

1    Department of Radiology, Shinshu University School of Medicine, 3-1-1 Asahi, Matsumoto, Nagano, 390-8621, Japan.
2    Diagnostic Imaging Center, The Canter Institute Hospital of Japanese Foundation for Cancer Research, 3-8-21 Ariake, Koto, Tokyo, 135-8550, Japan.
3    First Department of Surgery, Shinshu University School of Medicine, 3-1-1 Asahi, Matsumoto, Nagano, 390-8621, Japan.

Abstract
AIM:

To enhance the usefulness of splenic perfusion evaluated by means of dynamic computed tomography (CT) and of spleen size in assessing the degree of liver fibrosis.
METHODS:

We retrospectively studied 133 patients who had undergone dynamic CT before hepatectomy. Fibrosis was histologically established in all. First we calculated splenic perfusion parameters K1 (inflow rate constant), 1/k2 (Mean Transit Time: MTT), and K1 /k2 (distribution volume: Vd ), using compartment model analysis. Then we compared the stage of fibrosis with splenic perfusion and spleen size (long axis: R), using the Kruskal-Wallis test and multiple comparisons. After that, we assessed the diagnostic accuracy of the combination of splenic perfusion, spleen size, age, gender, the presence or absence of hepatitis B viral (HBV) infection, and that of hepatitis C viral (HCV) infection, in detecting liver fibrosis, using stepwise regression and receiver operating characteristic (ROC) analysis.
RESULTS:

Significant differences (p < 0.05) in MTT were observed in comparisons between F0 and F4, between F1 and F4, and between F2 and F4. Significant differences (p < 0.05) in R were observed in comparisons between F0 and F4, and between F1 and F4. Considering the presence or absence of HBV/HCV infection along with MTT and R, the areas under the ROC curves (AUROC) were 0.89 for ≧F1, 0.83 for ≧F2, 0.82 for ≧F3, and 0.82 for F4.
CONCLUSION:

Splenic MTT and spleen size are helpful in assessing liver fibrosis.

This article is protected by copyright. All rights reserved.
KEYWORDS:

Liver fibrosis; Multidetector Computed Tomography; Perfusion; Portal hypertension; Spleen

StephenW

Hepatol Res。 2017年4月1日。doi：10.1111 / hepr.12900。 [提前印刷]
使用动态CT评估脾灌注和脾脏大小：评估肝纤维化程度的有用性。
Suzuki T1，Yamada A1，Komatsu D1，Kurozumi M1，Fujinaga Y1，Ueda K2，Miyagawa S3，Kadoya M1。
作者信息

1
    日本松本大学医学部放射科，长野松本松本3-1-1-1-1。
2
    诊断影像中心，日本癌症研究基金会坎特研究所医院，日本东京脑卒中3-8-21，日本东京135-8550。
3
    日本首都松本大学医学部第一外科系，长野松本市松本3-1-1-1-1。

抽象
目标：

通过动态计算机断层扫描（CT）和脾脏尺寸评估肝纤维化程度来增强脾灌注的有用性。
方法：

我们回顾性研究了133例肝切除术前动态CT患者。纤维化在所有组织学上成立。首先，我们使用室模型分析计算脾灌注参数K1（流入速率常数），1 / k2（平均运输时间：MTT）和K1 / k2（分布体积：Vd）。然后，我们使用Kruskal-Wallis检验和多次比较比较了纤维化与脾灌注和脾脏大小（长轴：R）的关系。之后，我们评估了脾脏灌注，脾脏大小，年龄，性别，乙型肝炎病毒（HBV）感染和丙型肝炎病毒（HCV）感染的存在或不存在，检测肝纤维化的诊断准确性，使用逐步回归和接收机操作特性（ROC）分析。
结果：

在F0和F4之间，F1和F4之间以及F2和F4之间的比较中观察到MTT中的显着差异（p <0.05）。在F0和F4之间以及F1和F4之间的比较中观察到R中的显着性差异（p <0.05）。考虑到HBV / HCV感染与MTT和R的存在或不存在，ROC曲线（AUROC）的面积分别为≧F1为0.89，≧F2为0.83，≧F3为0.82，F4为0.82。
结论：

脾脏MTT和脾脏大小有助于评估肝纤维化。

本文受版权保护。版权所有。
关键词：

肝纤维化;多检测计算机断层扫描灌注;门静脉高压脾