| 易盈,金科,陈文坚,向永华,蔡齐芳.动态增强磁共振定量参数评估儿童先天性胆总管囊肿致肝纤维化[J].中国医学影像技术,2020,36(3):420~424 |
| 动态增强磁共振定量参数评估儿童先天性胆总管囊肿致肝纤维化 |
| Dynamic contrast enhanced MRI quantitative parameters for evaluation of liver fibrosis in children with congenital choledochal cyst |
| 投稿时间：2019-07-17 修订日期：2020-01-17 |
| DOI：10.13929/j.issn.1003-3289.2020.03.025 |
| 中文关键词: 肝硬化 血流动力学 胆总管囊肿 磁共振血管造影术 |
| 英文关键词:liver cirrhosis hemodynamics choledochal cyst magnetic resonance angiography |
| 基金项目:湖南省医药卫生科学技术研究项目（B2017112）。 |
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| 中文摘要: |
| 目的 探讨动态增强磁共振（DCE-MRI）定量参数评估儿童先天性胆总管囊肿（CCC）所致肝纤维化的价值。方法 纳入33例CCC致肝纤维化患儿（病例组），以14例无肝肾疾患儿童为对照组。采集肝脏DCE-MRI后，拟合Tofts模型，获得参数Ktrans、Kep及Ve，观察不同肝纤维化分期定量参数差异及其相关性，以ROC曲线分析各参数诊断肝纤维化的AUC和最佳截界值。结果 Ktrans、Kep在不同纤维化亚组间差异均有统计学意义（P均<0.05），且随肝纤维化程度增加而下降（r=-0.764、-0.720，P均<0.05）；Ve在不同纤维化亚组中差异无统计学意义（P>0.05），与肝纤维化程度无明显相关（r=-0.249，P>0.05）。Ktrans、Ke判别正常与肝纤维化、轻度与重度肝纤维化的AUC分别为0.949、0.748和0.933、0.731，截界值分别为0.239、0.186和1.814、1.663。结论 DCE-MRI定量灌注参数Ktrans、Kep对诊断儿童CCC致肝纤维化及其分期具有一定价值。 |
| 英文摘要: |
| Objective To investigate the value of dynamic contrast enhanced MRI (DCE-MRI) quantitative parameters for evaluation of liver fibrosis caused by pediatric congenital choledochal cyst (CCC). Methods Totally 33 CCC children with liver fibrosis were included into case group, while 14 children were selected as control group. All children underwent liver DCE-MRI. Quantitative parameters were acquired with Tofts model,including volume transfer constant from blood plasma to extravascular extracellular space (Ktrans), transfer rate constant between extravascular extracellular space and blood plasma (Kep) and volume of extravascular extracellular space (Ve). The differences and correlations of the above parameters among different liver fibrosis stages were analyzed, and AUC of each parameter in diagnosing different grades of liver fibrosis were drawn. Results Ktrans and Kep were significantly different among fibrosis subgroups (all P<0.05), which decreased with liver fibrosis progressed (r=-0.764, -0.720, both P<0.05). Ve showed no statistical significant difference among three subgroups (P>0.05) and negative correlation with liver fibrosis staging (r=-0.249, P>0.05). AUC for identifying normal vs fibrosis and mild vs advanced fibrosis by Ktrans and Kep were 0.949, 0.748 and 0.933, 0.731, and the cutoff values were 0.239,.0.186 and 1.814, 1.663, respectively. Conclusion DCE-MRI perfusion parameters such as Ktrans and Kep are valuable for diagnosing and staging of liver fibrosis caused by CCC in children. |
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