中文摘要：

目的通过应用320排CT灌注（CTP）成像技术检查肝移植后肝动脉狭窄（HAS）患者的移植肝血流灌注情况，以明确HAS与缺血性胆道病变（ITBL）的关系，为HAS的治疗提供依据。方法收集肝移植后经320排CT血管成像（CTA）检查证实为中重度HAS的患者13例，根据经皮经肝胆管造影（PTC）检查是否有ITBL，将HAS患者分为无ITBI。组（5例）和ITBL组（8例）。分别对两组患者进行CTP检查，定量检测其肝动脉灌注量（HAP）、门静脉灌注量（PVP）、总肝灌注量（TLP），并计算肝动脉灌注指数（HPI），比较两组间各灌注量的差异。结果ITBL组与无ITBL组的HAP分别为（59．8±19．9）和（35．1±4．9）ml·min。·100ml，PVP分别为（125．4±27．3）和（166．2±21．1）ml·min’·100ml～，TLP分另0为（185．2±27．9）和（201．3±23．6）ml·min。·100ml。，HPl分别为（33．6±10．9）％和（18．2±1。9）％，两组间比较，HAP、PVP及HPI差异均有统计学意义（P〈0．05），TLP的差异无统计学意义（_P〉0．05）。结论CTP成像通过定量检测肝动脉、门静脉的血流灌注量，无创性地反映了移植肝的血流动力学变化情况；当肝移植后HAS患者的HAP和HPI升高及PVP降低时，应警惕ITBL的发生，为临床及时治疗HAs，预防ITBL的发生提供客观依据。

英文摘要：

Objective Using CT perfusion （CTP） technique, to investigate the graft perfusion changes in patients with hepatic artery stenosis （HAS） with or without ischemic-type biliary lesions （ITBL） after orthotopie liver transplantation （OLT）. Methods Thirteen recipients with HAS received CTP scan of the liver, including 8 with ITBL and 5 without ITBL. For all patients, the diagnosis of HAS was made by CTA, and the diagnosis of ITBL by percutaneous transhepatic cholangiography. CT perfusion indices were obtained, including hepatic artery perfusion （HAP）, portal vein perfusion （PVP）, total liver perfusion （TLP） and hepatic perfusion index （HPI）. Results Of the 13 patients with HAS, mean HAP in patients with and without ITBL was 59. 8 and 35.1 ml.min^-1.100 m1^-1 （P = 0. 021, two-tailed paired Student t test） ： mean PVP was 125. 4 and 166. 2 ml.min- 1.100 ml ^-1 （P = 0. 016） ; mean TLP was 185, 2 and 201.3 ml.min^- 1.100 ml^- 1 （P = 0. 306） ; and mean HPI was 33. 6 and 18. 2 （P = 0. 005）, respectively. Conclusion Using CTP technique, liver perfusion changes were reflected by measuring CTP indices noninvasively. Compared to those without ITBL in this study, HAP and HPI in patients with ITBL were higher and PVP was lower, which may be contributed to biliary inflammation.