The Correlation Study Between Quantitative Measurement By MSCT And Blood Serum NO,NOS And TNF-α In Hepatic Cirrhosis

Part 1 The compared research of liver volume by MSCT with age and gender in normal adultsObjective:To measure whole liver and left lobe and right lobe volumes in normal adults by 16-slice spiral CT and evaluate the correlation bettween liver volume in adults with height, weight, body suface area and body mass index.Methods:A total of 200 normal adults, 115 male, 85 female, from 20～80years old, with mean age 53.23±14.49 years old. The whole liver volume (LV),left liver lobe volume (L-LV)and right liver lobe volume (R-LV) were measured by 16-slice spiral CT using volume measurement software, and height, weight also measured.Results :1,There were significant differences between male and female in whole LV,L-LV and R-LV(p< 0.05). there was also significant difference among age groups in 20～40 years old,40～60 years old and60～80 years old,the whole LV and right or left LV showed the biggest among the different age group.2,The correlation rate of the liver volume with the weight in male and female were rM=0.511 (p=0.000),rF=0.368 (p=0.001) and with surface area were rM=0.543 (p=0.000),rF=0.406(p=0.000) and with body mass index were rM=0.458 (p=0.000),rF=0.320 (p=0.003) , however the age and height have no correlation with the liver volume in normal adouts.Conclusion:Multi-slice Spiral CT can be objectively shown the liver volume (LV),left liver volume (L-LV)and right liver volume (R-LV), normal liver volume have moderate correlation with body weight, body surface area and body mass index especial in male adults . We propose the normal referance range of the liver volume, which will play important role in clinical managment in liver disease.Part 2 The relationship analysis between liver volume by MSCT and Child-pugh grad in hepatic cirrhosis patiensObjective:To measure the liver volume with 16 slices helical CT between hepatic cirrhosis patients and normal control group , and evalute the relationship between the change of liver volme and Child-pugh degree in the hepatic cirrhosis .Methods:A total of 47 hepatic cirrhosis cases, 25 male, 22 female,from 20～80years old, with mean age 53.79±13.56 years old, All hepatic cirrhosis diagnosis by clinic ,19 cases in Child A , 20 cases in Child B , 8 cases in Child C. 200 case as normal control group, 115 male, 85 female, from 20～80years old ,with mean age 53.23±14.49 years old. Using the MSCT measurement software to measur liver volume .Results:The whole liver volume measurement in the males and femals in control group were 1259.91±303.35cm3 and 1146.29±291.59 cm3, respectively; Standard liver volume were 687.09±138.90cm3 and 653.14±153.65 cm3 ,respectively. The LV in Child B and C of hepatic cirrhosis patients were lower than that in normal control group, however there was higher in Child A group.Conclusion:The 16 slice helical CT can measure the hepatic volume. The changes of the liver volume were strong correlated with the severity of hepatic cirrhosis , which is helpful for better understanding patients liver reserve function .Part 3 The evaluation of serverity of hepatic cirrhosis by MSCT perfusion blood parameterObjective:To investigate the change rules of liver hemodynamic in different Child-pugh grading of hepatic cirrhosis patients by MSCT liver perfusion.Methods : MSCT perfusion was performed in 47 hepatic cirrhosis patients(25 male, 22 female,from 20～80years old ,with mean age 53.79±13.56 years old )and 30 normal adult as control group (18 male, 12 female,from 20～80years old ,with mean age 50.13±15.62 years old), blood flow (BF),blood volume(BV),mean transit time (MTT),permeability-surface (PS),hepatic arterial fraction (HAF),IRF time of arrival (IRF-TO) were measured by perfusion CT software, and analysis the correlation between these MSCT perfusion parameters and severity with hepatic cirrhosis.Results:The BF,BV,MTT and IRF-TO were gradually decreased in hepatic cirrhosis compared with normal control group, the values in Child A were 165.89±11.69ml·min-1·ml-1,29.08±2.48ml/g,7.95±2.36s,4.27±0.87s;in Child B, 138.01±11.08ml·min-1·ml-1,18.12±2.98ml/g,6.91±1.18s,2.78±0.61s;Child C:111.04±15.64ml·min-1·ml-1,12.87±2.10ml/g,6.29±1.22s,1.85±0.60s, respectively; however, PS and HAF were gradually increasing, in Child A, 28.42±5.82 ml·100mg-1·min-1,0.24±0.05;Child B: 32.44±6.45 ml·100mg-1·min-1,0.39±0.13;in Child C 41.93±7.12 ml·100mg-1·min-1,0.54±0.07。Conclusion:MSCT perfusion imaging is valuable in diagnosis hepatic cirrhosis the severity. Part 4 The correlation study between perfusion arameter by MSCT and blood serum NO,NOS and TNF-αin thehepatic cirrhosisObjective:To study the change and correlation between NO,NOS and TNF-αin patients with hepatic cirrhosis and evaluate the correlation with perfusion parameter(BF,BV,MTT,PS,HAF,IRT-TO) .Methods:The 35 patients (22 male, 13 female,from 20～80years old ,with mean age 54.88±14.67 years old) with hepatic cirrhosis, and 5 healthy aduts as control group (3 male, 2 female, from 50～70years old, with mean age 53.23±20.55 years old ), both patients and control groop were performed MSCT perfusion images and perfusion parameters (BF,BV,MTT,PS,HAF,IRT-TO) were measured. Blood serum were examed, TNF-αby ELISA and NO,NOS by EIA.Results:The NO,NOS,TNF-αin hepatic cirrhosis patients were significantly higher than that in normal control group(p<0.05). There was significant correlation between NO and MSCT perfusion parameters BF,BV,PS,HAF,IRF-TO : BF(r=-0.825 p=0.000);BV(r=-0.829 p=0.000);PS(r=0.596 P=0.000);HAF(r=0.860 p =0.000);IRF-TO(r=-0.856 p =0.000), respectively. There was also shown significant correlation between TNF-αand perfusion parameters MTT,HAF,IRF-TO : MTT(r=-0.831 p=0.037),HAF(r=0.259 p=0.034);IRF-TO(r=-0.358 p=0.035), respectively.Conclusion:Blood serum NO,NOS TNF-αwere elevated in hepatic cirrhosis,MSCT perfusion parameters have closely correlation with Blood serum NO,NOS TNF-α, which play very important role in explain the mechanim of hepatic cirrhosis.