摘要目的:探讨CT动脉增强分数(arterial enhancement fraction,AEF)评估肝硬化患者肝功能损伤程度的可行性及临床价值.方法:前瞻性招募符合纳入及排除标准的52例肝硬化患者(Child-Pugh A,B,C级肝硬化患者组分别为13,20及19例)和17例无肝脏疾病者作为对照.受试者均行肝3期增强CT扫描,利用CT Kinetics软件进行后处理获得AEF彩图及其定量参数肝AEF(hepatic AEF,HAEF)、肝与脾AEF比值(H/S).比较不同Child-Pugh级别间HAEF,H/S的差异,并计算受试者工作特征曲线下面积(area under the receiver operating characteristic curve,AUROC),对肝硬化患者的HAEF,H/S与终末期肝病模型(model for end-stage liver disease,MELD)评分进行Spearman相关性分析.结果:HAEF,H/S的观察者间一致性高,组内相关系数(intraclass correlation coefficient,ICC)分别为0.918(95％ CI:0.871～0.949),0.946(95％ CI:0.915～0.966).对照组与Child-Pugh A,B,C级肝硬化患者组间的HAEF,H/S差异有统计学意义(均P＜0.001);肝硬化患者HAEF,H/S随Child-Pugh分级增加呈升高趋势,且除Child-PughA级组与B级组H/S外差异均有统计学意义(均P＜0.001).在所有肝硬化患者中,HAEF,H/S用于诊断Child-Pugh A级的AUROC分别为0.933,0.821;用于诊断Child-Pugh C级的AUROC分别为0.925,0.915.肝硬化患者HAEF,H/S与MELD评分呈显著正相关(HAEF:r=0.752,P＜0.001;H/S:r=0.676,P＜0.00l).结论:CT AEF相关参数HAEF,H/S与肝硬化严重程度及预后密切相关,能简单、有效地评估肝功能损伤状况.