目的应用双能CT的碘定量功 能，探讨肝硬化血流动力学改变与肝功 能储备Child-Turcotte-Pugh(CTP)评分 相关性。方法 选择55例临床确诊肝硬 化患者(肝硬化组)及26例健康者(对照 组)，对肝硬化组进行肝功能CTP评分及 分级(Child-Pugh A/B/C=30/15/10)，所 有对象均行双能CT三期增强扫描，应用 能谱分析软件得到肝实质动脉期碘浓度 Ia及门静脉期碘浓度Ip，并计算出肝动 脉碘分数(AIF=Ia/Ip)，静脉期与动脉期 碘浓度之差即门静脉碘浓度(PVIC=IpIa)，对照组及不同CTP分级肝硬化组的 灌注参数进行单因素分析，组间两两比 较，灌注参数与CTP评分相关性采用直 线相关分析，P<0.05认为差异具有统计 学意义。结果 肝硬化组Child-Pugh C 级 Ia高于对照组及Child-Pugh A、B; 肝硬化组Child-Pugh A、B、C级Ip、 PVIC均分别低于对照组;肝硬化组ChildPugh B、C级肝动脉碘分数高于对照组， 且差异具有统计学意义(P<0.05)。肝硬 化组CTP评分与Ia(r=0.649,P<0.01)、 AIF(r=0.848,P<0.01)呈正相关，与 Ip(r=-0.291，P=0.033)、PVIC(r=- 0.548，P<0.01)呈负相关。结论 肝硬化 组与正常肝脏组间动脉期、门静脉期碘浓 度及比例存在差异，且与肝功能储备CTP 评分存在不同程度相关。

Objective To investigate the liver cirrhosis hemodynamics and the correlation with Child-Turcotte-Pugh(CTP ) score by using the iodometry function of dual-energy CT. Methods 55 cases of liver cirrhosis (as study group) and 26 cases without liver disease (as control group) were selected in this study. CTP score and grade were proceed in liver cirrhosis group (Child-Pugh A/B/C n=30/15/10), and all groups underwent Dualenergy CT with three enhanced phases. The liver iodine concentration of arterial phase and portal venous phase(Ia and Ip) were measured by gemstone spectral imaging software, the arterial iodine fraction (AIF=Ia/Ip) and the portal venous iodine concentration (PVIC=Ip-Ia) were calculated. ALL parameters from study group and control group were compared by single factor analysis, and the different between groups were analysis among pairs, the correlation between parameters and CTP score were evaluated by linear correlative analysis with the statistical significance of P<0.05. Results Ia of liver cirrhosis group Child-Pugh grade C higher was than control group, Child-Pugh grade A and B; Ip and PVIC of Child-Pugh grade A, B, C were lower than control group respectively; AIF of Child-Pugh grade B,C were higher than control group, and the difference is statistically significant (P<0.05). Liver cirrhosis group CTP score and Ia (r=0.649, P<0.01), AIF (r=0.848, P<0.01) were positively correlated, CTP score and Ip (r=-0.291, P=0.033), PVIC (r=-0.548, P<0.01) were negatively correlated. Conclusion The iodine concentration and ratio of arterial and portal venous phase was different between liver cirrhosis group and control group, which have different degree of correlation with hepatic function reserve CTP score.