本文關(guān)鍵詞： 肝硬化 動(dòng)態(tài)對(duì)比增強(qiáng)磁共振 血流動(dòng)力學(xué) 滲透參數(shù) 灌注參數(shù)　出處：《中國(guó)醫(yī)學(xué)計(jì)算機(jī)成像雜志》2017年05期 　論文類型：期刊論文

【摘要】：目的:探討動(dòng)態(tài)對(duì)比增強(qiáng)MRI(DCE-MRI)定量分析技術(shù)對(duì)肝炎后肝硬化的評(píng)估價(jià)值。方法:符合入組標(biāo)準(zhǔn)的肝硬化代償期和失代償期患者各10例,正常對(duì)照組10例,行肝臟DCE-MRI掃描,通過(guò)Extended Tofts血流動(dòng)力學(xué)模型測(cè)得各組滲透參數(shù)(Ktrans、Kep、Ve、Vp)和灌注參數(shù)(HPI、BV、BF、MTT)。對(duì)各組定量參數(shù)行統(tǒng)計(jì)學(xué)分析并繪制受試者工作曲線(ROC)分析各參數(shù)的診斷效能。結(jié)果:肝硬化組Ktrans值低于正常組(P0.05),其中失代償期肝硬化組較正常組Ktrans降低(P0.05)。肝硬化組Ve高于正常組(P0.05),其中失代償期肝硬化組Ve較正常組升高具有統(tǒng)計(jì)學(xué)意義(P0.05)。肝硬化組HPI和MTT均高于正常組(P0.05),且三組間兩兩比較差異均有統(tǒng)計(jì)學(xué)意義(P0.05)。肝硬化組BF低于正常組且差異具有統(tǒng)計(jì)學(xué)差異(P0.05)。三組間BV值、Kep值及Vp值均無(wú)統(tǒng)計(jì)學(xué)差異(P0.05)。根據(jù)各參數(shù)ROC,當(dāng)HPI為0.54,MTT為0.29時(shí),診斷代償期肝硬化的敏感性(85%、85%)和特異性(75%、75%)之和最大。當(dāng)HPI為0.695,MTT為0.528時(shí),診斷失代償期肝硬化敏感性(95%、90%)及特異性(80%、80%)之和最大。當(dāng)Ktrans為0.415,Ve為0.283時(shí),診斷失代償期肝硬化敏感性(90%、100%)及特異性(100%、80%)之和最大。結(jié)論:DCE-MRI定量分析技術(shù)能夠反映肝硬化的血流動(dòng)力學(xué)改變及血管微環(huán)境變化,可用于評(píng)估肝硬化的嚴(yán)重程度并對(duì)其進(jìn)行分級(jí)。
[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.
【作者單位】： 河南中醫(yī)藥大學(xué)第一附屬醫(yī)院磁共振科;復(fù)旦大學(xué)附屬華山醫(yī)院靜安分院放射科;
【基金】：河南省科技攻關(guān)項(xiàng)目No 162102310104~~
【分類號(hào)】：R445.2;R575

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