Exchange模型的DCE-MRI定量研究评价肝硬化的价值

发布时间：2018-12-11 08:48

【摘要】：目的探讨Exchange模型的动态对比增强磁共振(DCE-MRI)定量研究评价肝硬化的价值。方法符合纳入标准和排除标准的肝硬化代偿期和失代偿期患者各15例,正常对照组15名,均行肝脏DCE-MRI扫描,采用Exchange模型计算出各组定量参数,包括对比剂容积转运常数(Ktrans)、速率常数(Kep)、血管外细胞外间隙容积分数(Ve)、血浆容积分数(Vp)、肝动脉灌注指数(HPI)、血容量(BV)、血流量(BF)、对比剂平均通过时间(MTT)。3组定量参数的比较采用单因素方差分析,组间两两比较采用LSD-t检验。绘制ROC曲线判断Ktrans、Ve、HPI、MTT对肝硬化的诊断效能。结果正常对照组、代偿期肝硬化组和失代偿期肝硬化组的Ktrans分别为(0.85±0.34)min~(-1)、(0.67±0.36)min~(-1)、(0.39±0.18)min~(-1),Ve分别为0.47±0.42、0.34±0.13、0.16±0.06,HPI分别为0.35±0.09、0.57±0.17、0.76±0.20,MTT分别为(17.38±15.38)s、(34.26±11.37)s、(57.33±16.73)s,BF值分别为(97.22±36.29)ml/(min·100g)、(69.30±35.22)ml/(min·100g)、(24.64±28.24)ml/(min·100g),差异均有统计学意义(P0.05),且HPI和MTT的组间两两比较差异有统计学意义(P0.05)。Kep、Vp、BV在3组间比较差异无统计学意义(P0.05)。Ktrans和Ve判断失代偿期肝硬化的曲线下面积(AUC)为0.86、0.92,敏感度为90%、90%,特异度为80%、80%;HPI和MTT判断代偿期肝硬化的AUC为0.79、0.76,敏感度为85%、85%,特异度为75%、75%;HPI和MTT判断失代偿期肝硬化的AUC为0.91、0.88,敏感度为95%、90%,特异度为80%、80%。结论 Exchange模型的DCE-MRI定量研究获得多个定量参数,可反映肝硬化的血流动力学改变及血管微环境变化,评价肝硬化的严重程度。
[Abstract]:Objective to evaluate the value of dynamic contrast enhanced magnetic resonance (DCE-MRI) quantitative study in evaluating liver cirrhosis in Exchange model. Methods liver DCE-MRI scanning was performed in 15 patients with liver cirrhosis and 15 patients with decompensated cirrhosis who met the criteria of inclusion and exclusion. The quantitative parameters of each group were calculated by Exchange model. Including contrast agent volume transport constant (Ktrans), rate constant (Kep), extracellular space volume fraction (Ve), plasma volume fraction (Vp), hepatic artery perfusion index (HPI), blood volume (BV), blood flow (BF), The average pass time of contrast agent (MTT). 3 group quantitative parameters were compared by single factor ANOVA, and the two groups were compared by LSD-t test. ROC curve was drawn to evaluate the effectiveness of Ktrans,Ve,HPI,MTT in the diagnosis of liver cirrhosis. Results the Ktrans of normal control group, compensatory cirrhosis group and decompensated cirrhosis group were (0.85 卤0.34) min~ (-1), (0.67 卤0.36) min~ (-1), (0.39 卤0.18) min~ (-1), respectively. Ve was 0.47 卤0.42) s, (0.34 卤0.13) s, (0.16 卤0.06) s, (0.35 卤0.09) s, (0.57 卤0.17) s, (0.76 卤0.20) s, (, respectively, and was (17.38 卤15.38) s, (34.26 卤11.37) s, (57.33 卤16.73) s, respectively. BF was (97.22 卤36.29) ml/ (min 100g), (69.30 卤35.22) ml/ (min 100g), (24.64 卤28.24) ml/ (min 100g), the difference was significant (P0.05). The difference between HPI and MTT was statistically significant (P0.05). Kep,Vp, There was no significant difference in BV among the three groups (P0.05). The area under the curve of). Ktrans and Ve for the diagnosis of decompensated cirrhosis was 0.86 卤0.92, the sensitivity was 900.90 and the specificity was 80. The AUC of compensatory cirrhosis by HPI and MTT was 0.79 卤0.76, the sensitivity was 850.85 and the specificity was 7575. HPI and MTT showed that the AUC of decompensated cirrhosis was 0.91 卤0.88, the sensitivity was 950.90, and the specificity was 800.80. Conclusion multiple quantitative parameters can be obtained in the quantitative study of Exchange model, which can reflect the changes of hemodynamics and vascular microenvironment in liver cirrhosis and evaluate the severity of cirrhosis.
【作者单位】：河南中医药大学第一附属医院磁共振科;郑州大学第一附属医院磁共振科;
【基金】：河南省科技攻关项目(162102310104)
【分类号】：R575.2

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