动态对比增强磁共振在肝炎后肝硬化中的定量研究

发布时间：2018-02-24 19:33

本文关键词： 肝硬化动态对比增强磁共振血流动力学渗透参数灌注参数　出处：《中国医学计算机成像杂志》2017年05期 　论文类型：期刊论文

【摘要】：目的:探讨动态对比增强MRI(DCE-MRI)定量分析技术对肝炎后肝硬化的评估价值。方法:符合入组标准的肝硬化代偿期和失代偿期患者各10例,正常对照组10例,行肝脏DCE-MRI扫描,通过Extended Tofts血流动力学模型测得各组渗透参数(Ktrans、Kep、Ve、Vp)和灌注参数(HPI、BV、BF、MTT)。对各组定量参数行统计学分析并绘制受试者工作曲线(ROC)分析各参数的诊断效能。结果:肝硬化组Ktrans值低于正常组(P0.05),其中失代偿期肝硬化组较正常组Ktrans降低(P0.05)。肝硬化组Ve高于正常组(P0.05),其中失代偿期肝硬化组Ve较正常组升高具有统计学意义(P0.05)。肝硬化组HPI和MTT均高于正常组(P0.05),且三组间两两比较差异均有统计学意义(P0.05)。肝硬化组BF低于正常组且差异具有统计学差异(P0.05)。三组间BV值、Kep值及Vp值均无统计学差异(P0.05)。根据各参数ROC,当HPI为0.54,MTT为0.29时,诊断代偿期肝硬化的敏感性(85%、85%)和特异性(75%、75%)之和最大。当HPI为0.695,MTT为0.528时,诊断失代偿期肝硬化敏感性(95%、90%)及特异性(80%、80%)之和最大。当Ktrans为0.415,Ve为0.283时,诊断失代偿期肝硬化敏感性(90%、100%)及特异性(100%、80%)之和最大。结论:DCE-MRI定量分析技术能够反映肝硬化的血流动力学改变及血管微环境变化,可用于评估肝硬化的严重程度并对其进行分级。
[Abstract]:Objective: to evaluate the value of dynamic contrast enhanced MRICE-MRI quantitative analysis in the evaluation of posthepatitic cirrhosis. Methods: ten patients with compensatory stage of cirrhosis and 10 patients with decompensated stage and 10 patients with normal control were examined with DCE-MRI. The Extended Tofts hemodynamic model was used to measure the osmotic parameters of Ktranskepa Vpand the perfusion parameters. The quantitative parameters of each group were statistically analyzed and the working curve was drawn to analyze the diagnostic efficacy of each parameter. Results: the Ktrans value of cirrhosis group was determined. It is lower than the normal group (P 0.05), and the decompensated cirrhosis group is lower than the normal group (P 0.05). The ve of the liver cirrhosis group is higher than that of the normal group (P 0.05), and the ve of the decompensated cirrhosis group is higher than that of the normal group (P 0.05). The HPI and MTT of the cirrhosis group are higher than that of the normal group. The BF of liver cirrhosis group was lower than that of normal group (P 0.05). There was no significant difference in BV value, Kep value and VP value between three groups. The sum of sensitivity and specificity in the diagnosis of compensatory cirrhosis is the largest. When HPI is 0.695MTT is 0.528, the sensitivity of diagnosing decompensated cirrhosis is 959090g) and the specificity is 80%). When Ktrans is 0.415Ve is 0.283, Conclusion the quantitative analysis technique of DCE-MRI can reflect the changes of hemodynamics and microenvironment of liver cirrhosis, and can be used to evaluate the severity of cirrhosis and grade it.
【作者单位】：河南中医药大学第一附属医院磁共振科;复旦大学附属华山医院静安分院放射科;
【基金】：河南省科技攻关项目No 162102310104~~
【分类号】：R445.2;R575

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