目的:用四维CT(four-dimensional computed tomography,4DCT)的方法研究膈肌和肝脏各部分的呼吸移动度,并分析它们之间的关系.方法:对31例有肝脏内占位性病灶的患者行静脉增强4DCT扫描,在生成的10个呼吸时相的CT图像上分别勾画膈肌、肝脏内占位性病灶并测量其呼吸移动度.结果:膈肌在头脚方向上的呼吸移动度为(9.9±3.8)mm.肝脏各部分的呼吸移动度不等,肝右叶上部、肝左叶、肝中部与膈肌头脚方向的呼吸移动度均无显著差异(P＞0.05),经线性相关分析,呈高度线性正相关(相关系数分别为0.997、0.985、0.996,P＜0.05).肝右叶下部、肝门区的移动度均显著小于膈肌的呼吸移动度(P＜0.05).结论:肝脏各部分的呼吸移动度不同,膈肌呼吸移动度可以代表肝右叶上部、肝中部和肝左叶在头脚方向的呼吸移动度.%Objective:To study the respiratory motion of diaphragm and different parts of liver using four-dimensional computed tomography(4DCT) imaging,and to investigate the relationship between them. Methods: A total of 31 patients with intrahe-patic space-occupying lesions were scanned using 4DCT imaging with synchronized intravenous contrast injection. Diaphragm and intrahepatic space-occupying lesions were contoured respectively on CT images in 10 respiratory phases. The motions of diaphragm and intrahepatic space-occupying lesions were measured. Results: The motion of diaphragm in the cranio-caudal(CC) direction was (9. 9 ± 3. 8)mm. The CC movement of the superior part of right lobe, the left lobe and the central part correlated well with the diaphragmatic movement, and the correlation coefficients of them were 0. 997,0. 985 and 0. 996, respectively(P＜ 0. 05), and no significant differences were observed(P＞0. 05). The displacement of diaphragm in the CC direction was more notable than that of the inferior part of right lobe and that of the hepatic hilar part (P＜0. 05). Conclusions: The displacement during respiration is different in different parts of liver. The breathing motion of diaphragm approximate the CC movement of the superior part of right lobe, the left lobe and the central part of liver.
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