中文摘要：

目的比较活体肝移植术后1个月患者与无肝脏病变者的CT灌注参数，评价移植物肝右静脉和肝中静脉所引流区域血流动力学的改变。方法对肝移植术后1个月、临床无术后并发症的20例患者及对照组25名正常志愿者行动态16排螺旋CT灌注扫描。CT灌注扫描后，选取适当靶层面，将每一层面的移植物按照肝右、肝中静脉引流区分为淤血区、淤血风险区和参考区，对照组亦作类似分区，并分别绘制出时间-密度曲线（TDc）和灌注图像，计算相关灌注参数值和相对灌注差异（RPD）。结果肝移植术后围手术期患者前段易淤血区、淤血风险区相对灌注差异RPD分别为：BF（44．56±43．19）ml／（min·100g）和（25．41±27．49）ml／（min·100g），BV（3．91±2．45）ml／100g和（2．15±1．86）ml／100g，PVP（41．50±39．15）ml／（min·100g）和（22．66±23．82）ml／（min·100g）；前段BF、BV、PVP的相对灌注差异RPD与对照组间的差异有统计学意义（P〈0．0001），淤血风险区BF、BV、PVP差异亦有统计学意义（P〈0．01）。结论肝移植术后围手术期，肝右静脉和肝中静脉所引流肝段血流动力学存在差异；与肝右静脉引流区相比，肝中静脉单独引流的前段灌注最低，肝右、肝中静脉共同引流区次之。

英文摘要：

Objective To compare CT perfusion changes of patients 1 month after living liver transplantation with healthy volunteers. Methods Twenty perioperative patients without complications and 25 healthy volunteers underwent dynamic multi-slice CT scan. On each targeted slice, liver was divided into 3 regions of interest （ROD according to hepatic venous drainage, i.e. anterior segment area drained by middle hepatic veins （MHV） which was most likely congested, risk area drained by both MHV and RHV which was posterior to anterior segment, reference area drained by RHV. Perfusion param eters and relative perfusion difference were calculated. Results The relative perfusion differences of anterior segment and risk area in study group were as follows.. BF 44.56±43.19 vs 25.41±27.49 [ml/（min. 100 g）]; BV 3.91±2.45 vs 2.15± 1.86（ml/100 g）; PVP 41. 505±39.15 vs 22. 665±23.82 [ml/（min · 100 g）]. Significant differences of RPDs of BF, BV and PVP were found in anterior segment （P〈0. 0001） and risk area （P〈0.01） compared with control group. Conclusion In perioperative period, there are hemodynamic differences in hepatic segments drained by RHV and MHV. BF, BV, PVP of anterior segment decreases obviously.