目的 探讨64排螺旋CT肝脏灌注 评价血吸虫性肝硬化的临床应用价值。方 法 64排螺旋CT肝脏灌注成像76例，其中 20例轻度血吸虫性肝硬化，18例中度血吸 虫性肝硬化，25例重度血吸虫性肝硬化， 健康志愿者及因其他疾病行腹部CT检查者 13例作为对照组，测量各组的肝脏灌注参 数，包括肝血容量(BV)、肝血流量(BF)、 对比剂平均通过时间(MTT)、肝动脉分数 (HAF)、肝动脉灌注量(HAP)等5个指标， 对获得的各组不同的肝脏灌注参数进行肝 硬化分级分析。结果 对照组、轻度血吸 虫性肝硬化组、中度血吸虫性肝硬化组、 重度血吸虫性肝硬化组BV值、BF值随着血 吸虫性肝硬化程度的加重逐步下降，各组 间差异有统计学意义(P值均<0.01)；上述 各组MTT值、HAF值、HAP值随着血吸虫性 肝硬化程度的加重逐步增高，各组间差异 亦均有统计学意义(P值均<0.05)，BV与BF 与血吸虫性肝硬化严重程度呈显著负相关 关系，而MTT、HAF、HAP则与血吸虫性肝 硬化严重程度呈正相关关系。结论 64排 螺旋CT灌注成像参数能反映血吸虫性肝硬 化的血流动力学改变，对临床上血吸虫性 肝硬化分级评估有一定的价值，对血吸虫 性肝硬化的早期诊断、治疗及疗效的观察 有重要价值。

Objective To investigate the clinical application of hepatic perfusion imaging of 64-slice spirl CT in schistosomiasis cirrhosis. Methods 64-slice spirl CT hepatic perfusion imaging in 76 cases, inside, mild schistosomiasis cirrhosis in 20 cases,moderate schistosomiasis cirrhosis in 18 cases and severe schistosomiasis cirrhosis in 25 cases, healthy volunteers and other diseases underwent abdominal CT examination in 13 cases for control group.Measurement of liver perfusion parameters,include the blood volume(BV),blood flow(BF), contrast agent mean transit time(MTT),hepatic arterial fraction(HAF)and hepatic arterial infusion (HAP),liver cirrhosis grading analysis of different liver perfusion parameters in different groups. Results Control group、mild schistosomiasis cirrhosis group, moderate schistosomiasis cirrhosis group, severe schistosomiasis cirrhosis group, The BV, BF value decreased gradually with the increased degree of schistosomiasis cirrhosis, the difference between the groups was statistically significant (P values were less than 0.01). Above each group the MTT, HAF, HAP value increased gradually with the increased degree of schistosomiasis cirrhosis, the difference between the groups was statistically significant (P values were less than 0.05), The relationship between BF and BV was negatively correlated with the severity of schistosomiasis cirrhosis,and the relationship MTT、HAF and HAP was positively correlated with the severity of schistosomiasis cirrhosis. Conclusion 64-slice spirl CT perfusion imaging parameters can reflect the hemodynamic changes of the schistosomiasis cirrhosis of the liver in each group,there is a certain value for the clinical assessment of the schistosomiasis cirrhosis, the early diagnosis and treatment of the schistosomiasis cirrhosis and the effect of the observation have great value.