| 张岚,郑妍,邢威,程敬亮.Exchange模型的DCE-MRI定量研究评价肝硬化的价值[J].中国医学影像技术,2017,33(7):1019~1023 |
| Exchange模型的DCE-MRI定量研究评价肝硬化的价值 |
| Value of DCE-MRI quantification study with exchange model in evaluation of liver cirrhosis |
| 投稿时间：2017-02-05 修订日期：2017-05-21 |
| DOI：10.13929/j.1003-3289.201702007 |
| 中文关键词: 肝硬化 磁共振成像 血流动力学 Exchange模型 |
| 英文关键词:Liver cirrhosis Magnetic resonance imaging Hemodynamics Exchange model |
| 基金项目:河南省科技攻关项目（162102310104）。 |
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| 中文摘要: |
| 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·100 g）、（69.30±35.22）ml/（min·100 g）、（24.64±28.24）ml/（min·100 g），差异均有统计学意义（P<0.05），且HPI和MTT的组间两两比较差异有统计学意义（P<0.05）。Kep、Vp、BV在3组间比较差异无统计学意义（P>0.05）。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。 |
| 英文摘要: |
| Objective To investigate the value of dynamic contrast-enhanced MRI (DCE-MRI) quantitation study with exchange model in evaluation of liver cirrhosis. Methods A total of 30 patients with liver cirrhosis confirmed to included and excluded criteria were divided into compensatory cirrhosis group (n=15) and decompensatory cirrhosis group (n=15). And 15 healthy volunteers were served as a control group. All subjects were performed liver DCE-MRI and quantitative parameters of three groups were obtained by exchange model, including volume transfer constant of the contrast agent (Ktrans), reverse reflux rate constant (Kep), volume fraction of EES (Ve), volume fraction of plasma (Vp), arterial perfusion index (HPI), blood volume (BV), blood flow(BF) and mean transit time (MTT). The parameters of three groups were compared by ANOVA analysis and LSD test for every two groups. The diagnostic efficacy of Ktrans, Ve, HPI, MTT for liver cirrhosis were analyzed by ROC. Results Ktrans, Ve, HPI, MTT and BF values in the control group, compensatory cirrhosis group and decompensatory cirrhosis group were (0.85±0.34) min－1, (0.67±0.36) min－1, (0.39±0.18)min－1; 0.47±0.42, 0.34±0.13, 0.16±0.06; 0.35±0.09, 0.57±0.17, 0.76±0.20; (17.38±15.38)s, (34.26±11.37)s, (57.33±16.73)s; (97.22±36.29)ml/(min·100 g), (69.30±35.22)ml/(min·100 g), (24.64±28.24) ml/(min·100 g), respectively, and showing significant differences among three groups, and significant with HPI and MTT for every two groups (P<0.05). There were no significant differences for Kep, Vp and BV among three groups (P>0.05). According to ROC of Ktrans and Ve for decompensatory liver cirrhosis, AUC were 0.86, 0.92, the sensitivity were 90%, 90% and the specificity were 80%, 80%. According to ROC of HPI and MTT for compensatory liver cirrhosis, AUC were 0.79, 0.76, the sensitivity were 85%, 85% and the specificity were 75%, 75%. According to ROC of HPI and MTT for decompensatory liver cirrhosis, AUC were 0.91, 0.88, the sensitivity were 95%, 90% and the specificity were 80%, 80%. Conclusion DCE-MRI quantitative study with exchange model can obtain multiple parameters, reflect hemodynamic changes and vascular microenvironment and evaluate severity of liver cirrhosis. |
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