Non-invasive quantification of liver perfusion with dynamic computed tomography and a dual-input one-compartmental model
Non-invasive quantification of liver perfusion with dynamic computed tomography and a dual-input one-compartmental model
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DOI：
10.1042/cs20000080
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发表时间：
2000-12-01
期刊：
影响因子：
6
通讯作者：
Horsmans, Y
中科院分区：
文献类型：
--
作者：
Materne, R;Van Beers, BE;Horsmans, Y
各种肝脏疾病导致肝脏微循环的显著改变。因此，肝脏灌注的定量具有改善肝脏疾病的评估和管理的潜力。大多数用于量化肝脏灌注的方法是侵入性的或有争议的。本文介绍并验证了一种非侵入性的方法，利用计算机断层扫描（CT）的肝脏灌注定量。在静脉推注低分子量碘化造影剂后进行肝脏动态单切片CT。采用双输入一室模型拟合肝脏、主动脉及门静脉时间-密度曲线，计算肝脏灌注。验证研究包括在家兔休息时和腺苷输注后用CT和放射性标记微球同时测量肝脏灌注。由三名观察员在10名无肝病的患者中评估了CT方法在人类中的可行性和可重复性。在家兔中，观察到CT和微球获得的灌注测量值之间存在显著相关性（总肝脏灌注r = 0.92，动脉灌注r = 0.81，门静脉灌注r = 0.85）。在患者中，CT测量的总肝血浆灌注为112+/-28 ml.min（-1. 100 ml（-1），动脉血浆灌注为18+/-12 ml.min（-1. 100 ml（-1），门静脉血浆灌注为93+/-31 ml.min（-1. 100 ml（-1）。三位观察者的测量结果无显著性差异（P > 0.1）。我们的研究结果表明，动态CT结合双输入一室模型提供了一个有效的和可靠的方法，在正常肝脏灌注的无创定量。
Various liver diseases lead to significant alterations of the hepatic microcirculation. Therefore, quantification of hepatic perfusion has the potential to improve the assessment and management of liver diseases. Most methods used to quantify liver perfusion are invasive or controversial. This paper describes and validates a non-invasive method for the quantification of liver perfusion using computed tomography (CT). Dynamic single-section CT of the liver was performed after intravenous bolus administration of a low-molecular-mass iodinated contrast agent. Hepatic, aortic and portal-venous time-density curves were fitted with a dual-in put one-compartmental model to calculate liver perfusion. Validation studies consisted of simultaneous measurements of hepatic perfusion with CT and with radiolabelled microspheres in rabbits at rest and after adenosine infusion. The feasibility and reproducibility of the CT method in humans was assessed by three observers in 10 patients without liver disease. In rabbits, significant correlations were observed between perfusion measurements obtained with CT and with microspheres (r = 0.92 for total liver perfusion, r = 0.81 for arterial perfusion and r = 0.85 for portal perfusion). In patients, total liver plasma perfusion measured with CT was 112+/-28 ml.min(-1).100 ml(-1), arterial plasma perfusion was 18+/-12 ml.min(-1).100 ml(-1) and portal plasma perfusion was 93+/-31 ml.min(-1).100 ml(-1). The measurements obtained by the three observers were not significantly different from each other (P > 0.1). Our results indicate that dynamic CT combined with a dual-input one-compartmental model provides a valid and reliable method for the noninvasive quantification of perfusion in the normal liver.