3D DCEMRI对中重度慢性阻塞性肺疾病患者的肺灌注成像研究  

Pulmonary perfusion imaging with 3D DCEMRI in patients with moderate to severe chronic obstructive pulmonary disease

作　　者：夏艺[1] 范丽[1] 管宇[1] 刘士远[2] 张铁峰[1] 徐雪原[1] 赵洪波[1] 

机构地区：[1]第二军医大学附属长征医院影像科,上海200003 [2]第二军医大学附属长征医院呼吸科,上海200003

出　　处：《实用放射学杂志》2012年第3期363-366,371,共5页Journal of Practical Radiology

基　　金：上海市自然科学基金资助项目（10zr1438900）;国家自然科学基金青年基金资助项目（81000602）;国家自然科学基金资助项目（30970800）.

摘　　要：目的 评价中重度慢性阻塞性肺疾病（COPD）患者的3D动态增强MRI（3D DCEMRI）肺灌注成像的表现及与HRCT表现、肺功能检查（PFT）指标间的关系.方法 对20例中重度COPD患者分别进行PFT检查、3DHRCT扫描及3D DCEMRI灌注成像.评价不同HRCT表现型患者的3D DCEMRI灌注成像的表现特点,计算灌注缺损区与正常肺组织的信号强度之比（RSI）,在此基础上评价RSI与肺功能检查结果的相关性.结果 中重度COPD患者的肺MRI灌注成像主要表现为两肺广泛斑片状的灌注缺损;rSI分别与FEV1（r=0.468,P=0.037）、FEV1/FVC（r=0.578,P=0.008）及FEV1%（r=0.663,P=0.001）呈正相关.结论 3D DCEMRI可以评价中重度COPD患者的肺灌注情况,半定量分析指标RSI与肺功能指标具有正相关性.Objective To evaluate the correlation of the pulmonary perfusion imaging of 3 dimensional dynamic contrast-enhanced MRI （3D DCE MRI） with high resolution computed tomography （HRCT） findings and puhnonary function test （PFT） in patients with moderate to severe chronic obstructive pulmonary disease （COPD）. Methods Twenty patients with moderate to severe COPD underwent PFT, 3D-HRCTand contrast enhanced MR perfusion imaging. According to HRCT phenotypeof patients, the manifestations of MR perfusion images were visually assessed. Then, the signal intensity ratio （Rst） of the perfusion defects and normal lung perfusion was calculated. Finally, lhe correlation between the Rst and the parameters from PFT was assessed using Spearman correlation analysis. Results MR perfusion imaging manifestations in patients with moderate to severe COPD were generally patchy perfusion defects . The Rst was positively correlated with FEV1 （r= 0.468, P = 0. 037 ）, FEV1/FVC （r=0. 578, P = 0. 008 ） and FEV1%（r=0.663,P=0.001）. Conclusion Pulmonary perfusion imaging with 3D DCE-MRI in patients with moderate to severe COPD is feasible and consistent. The semiquantitativc index of Rst is positively correlated with the PFT parameters.

关 键 词：肺 慢性阻塞性肺疾病 磁共振成像 体层摄影术 X线计算机 

分 类 号：R563[医药卫生—呼吸系统] R445.2[医药卫生—内科学]