The Investigation In Evaluating Liver Functional Reserve Of Patients Suffering From Cirrhosis With Hepatic Perfusion CT Techniques

Objective: To investigate the features of hepatic perfusion parameters measured by MSCT in patients with primary liver cancer complicated by cirrhosis, and to clarify the correlation among the hepatic MSCT perfusion parameters,CT morphologic classification of hepatocirrhosis and hepatic Child-pugh functional classification, while the final destination was to reveal the role of perfusion CT techniques in evaluating liver functional reserve.Methods: 32 subjects with initial treatment suffering from primary hepatic carcinoma existing with cirrhosis were enrolled to undego hepatic MSCT perfusion scans, and test data, including pretherapeutic hepatic function, CT morphologic classification and MSCT perfusion parameters obtained in them, were appraised by spearman's correlation analysis,linear discriminate analysis and ROC curve.Results : The negative correlation was demonstrated between CT morphologic classification of hepatocirrhosis and BF, BV, IRF TO, PVP, while positive correlation was found between CT morphologic classification and MTT, HAF, HAP/PVP ratio. The coefficients correlation were -0.848, -0.801, -0.652, -0.864, 0.612, 0.822 and 0.824, respectively, and the significant differences had been showed up(p<0.05).However, there was no statistical significance for the correlation between CT morphologic classification of hepatocirrhosis and HAP(p=0.513).Homoioplastic information was also found in the relation between Child-pugh functional classification and hepatic MSCT perfusion parameters. The inverse correlation between Child-pugh functional class and BF, BV, IRF TO, PVP was validated. Just as CT morphologic classification, direct correlation was also been confirmed between Child-pugh functional classification and MTT, HAF, HAP/PVP ratio. The respective coefficient of correlation which had statistical differences was -0.888, -0.829, -0.539, -0.885, 0.670, 0.768 and 0.766(p<0.05), but no significant correlation was observed between Child-pugh functional classification and HAP (p=0.219) .As to the correlation between Child-pugh functional classification and CT morphologic classification , It is positive and significant correlation(p<0.05), and the coefficient correlation was 0.891.Based on canonical discriminant function,of all sufferers' original Child-pugh functional classification, 90.6% were correctly classified by hepatic perfusion parameters, while according to ROC curve, the respective classification coincidence of BF, BV and PVP in judging Child-pugh class was 90.6%, 87.5% an4 93.8%.Conclusions: The main hepatic perfusion parameters measured by CT were markly altered in cirrhosis and significantly correlated with the severity of the disease;There existed homoioplastic clinical significance in evaluating hepatic functional reserve between hepatic CT perfusion and Child-pugh functional classification, and owing to the objective and quantitative forte of its own, the hepatic CT perfusion may be available as a complemental method in evaluating the functional reserve of liver with hepatocirrhosis.