Study On Application Of Whole-liver Volume Perfusion Imaging In Patients With Hepatitis B, Cirrhosis By MCT

Objective：To explore the feasibility of assessing the severity of hepatitis B, hepatitis B cirrhosisby whole liver volume CT perfusion imaging (VCTP), to discovery the value of theperfusion parameters of liver left or right lobe and whole liver on evaluating the liverreserve function, to study the application of perfusion pseudo color map on the liverpuncture.Materials and methods:The objects brought into our prospective research undergoing whole liver volume CTperfusion imaging (VCTP) were composed of26patients with hepatitis B,24patients withhepatitis B cirrhosis in compensatory period,22patients with hepatitis B cirrhosis indecompensatory period, who were confirmed by clinical and other imaging examinations,and30cases in the control group. A total of five perfusion indexes included blood flow(BF), blood volume (BV), hepatic artery perfusion (ALP), portal vein perfusion (PVP) andhepatic artery perfusion index (HPI), which were generated automatically by software andanalyzed. Different groups of liver CT perfusion parameters were compared by one-wayANOVA analysis of variance, and there was multiple comparisons between groups. Theperfusion parameters of each group were compared by paired samples t test. The resultwould be statistically significant when the value of P was less than0.05.Result：As the degree of liver pathological change was aggravated, the values of BF, BV andPVP of liver right lobe, liver left lobe and whole liver gradually decreased, but the value ofHPI gradually increased, and the differences were statistically significant. The evaluationson liver function by liver right lobe, liver left lobe and whole liver perfusion parameterswere consistent, and there was no significant difference between the trend of the perfusion parameters of liver left and right lobe. The perfusion parameter of ALP had no statisticalsignificance. In terms of normal control group, when compared with hepatitis B group, thedifferences of BF of liver right lobe, left lobe and whole liver were statistically significant(P <0.05); when compared with compensatory period cirrhosis group, the differences ofBF, PVP of liver right lobe, left lobe and whole liver and the differences of BV of liver leftlobe and whole liver were statistically significant (P <0.05); when compared withdecompensatory period cirrhosis group, the differences of BF, BV, PVP and HPI of liverright lobe, left lobe and whole liver were statistically significant (P <0.05). In terms ofhepatitis B group, when compared with compensatory period cirrhosis group, thedifferences of PVP of liver right lobe, left lobe and whole liver and BV of liver left lobewere statistically significant (P <0.05); when compared with decompensatory periodcirrhosis group, the differences of BV, PVP and HPI of liver right lobe, left lobe and wholeliver and the differences of BF of liver right lobe and whole liver were statisticallysignificant (P <0.05). In terms of compensatory period cirrhosis group, when comparedwith decompensatory period cirrhosis group, the differences of BF, BV, PVP and HPI ofliver right lobe and HPI of whole liver were statistically significant (P <0.05).Conclusion：As MSCT whole liver volume perfusion imaging (VCTP) could reflect thehemodynamic changes of hepatitis B and hepatitis B cirrhosis, it can be applicated toassess the severity of hepatitis B and hepatitis B cirrhosis. As the degree of liverpathological change was aggravated, the blood perfusion of liver left lobe was more thanliver right lobe, but the evaluations on liver function by liver right lobe, liver left lobe andwhole liver perfusion parameters were consistent. The perfusion parameters of BF, BV andPVP of liver right lobe and left lobe gradually decreased, along with the aggravation of thedegree of liver pathological change, and the changes of liver right lobe wsere moresignificant than that of liver left lobe. Using pseudo color map obtained by whole livervolume perfusion, we can choose puncture site more clearly and intuitively, which canimprove the accuracy of liver biopsy greatly.