IVIM-DWI定量评价Lipo-PGE1对兔肝热缺血再灌注损伤的干预作用  

Evaluating Value of Lipo-PGE1 Intervening Hepatic Warm Ischemia-Reperfusion Injury in Rabbits with IVIM-DWI

作　　者：张玉玲 褚志强[3] 李婧瑶 任涛[2] 许诗超 季倩[2] ZHANG Yuling;CHU Zhiqiang;LI Jingyao(First Central Clinical College of Tianjin Medical University,300070,P.R.China)

机构地区：[1]天津医科大学一中心临床学院,300070 [2]天津市第一中心医院放射科,300192 [3]天津市第一中心医院移植科,300192

出　　处：《临床放射学杂志》2018年第12期2113-2118,共6页Journal of Clinical Radiology

基　　金：国家自然科学基金项目(编号:81301197);天津市卫计委攻关课题(编号:16KT109);江苏省博士后基金项目(编号:1601125B)

摘　　要：目的探讨体素内不相干运动扩散加权成像(IVIM-DWI)定量评价脂质体携载前列腺素E1(Lipo-PGE1)对兔肝热缺血再灌注损伤(WIRI)的干预作用。方法选取健康成年新西兰大白兔50只,随机分为5组,每组10只,即假手术组(T0组),30min、40min热缺血时间组(T1、T2组)及相应时间的Lipo-PGE1干预组(G1、G2组),再灌注6 h后行MR扫描。采用3.0T常规MRI和IVIM-DWI扫描,梯度因子(b)=0、20、40、60、80、100、150、200、400、600、800 s/mm^2。扫描结束后,采集兔外周血检测血清丙氨酸转氨酶(ALT)、天冬氨酸转氨酶(AST)和乳酸脱氢酶(LDH)水平,并行肝组织病理学检查。由两位资深影像学医师分别测量IVIM-DWI参数及表观扩散系数(ADC)值,使用组内相关系数(ICC)检验其一致性,多组均数差异的比较采用单因素方差分析,应用Spearman相关分析评价各参数值与血清ALT、AST、LDH之间的相关性。结果两位医师所测ADC、纯扩散系数(Dslow)、灌注相关扩散系数(Dfast)、灌注分数(PF)的ICC值分别为:0.933、0.882、0.692和0.839。多组间各IVIM参数间差异均具有统计学意义(P<0.05)。其中,T0组与各热缺血组、干预组ADC、Dslow及PF值之间差异具有统计学意义(P<0.05);干预组的ADC、Dslow及PF值较相应热缺血组明显上升,差异均具有统计学意义(P<0.05)。ADC、Dslow及PF值与血清ALT、AST、LDH之间均呈显著负相关(r >0.5,P<0.05)。热缺血组肝细胞弥漫性水肿、变性,可见点片状坏死及纤维组织增生,干预组较相应热缺血组损伤程度减轻。结论 3.0T IVIM-DWI能够无创、定量评价Lipo-PGE1对肝WIRI的保护作用。Objective To investigate the interventional effect of Lipo-PGE1 on hepatic WIRI in rabbits with intravoxel incoherent motion diffusion weighted imaging(IVIM-DWI).Methods Fifty healthy adult New Zealand white rabbits were randomly divided into five groups(n=10 for each group):sham group(T0 group),30 min and 40 min of warm ischemic group(T1 and T2)and interventional group(G1 and G2),Reperfusion for 6h.3.0T routine MRI and IVIM-DWI were performed with b values of 0,20,40,60,80,100,150,200,400,600,800 s/mm^2.After the scanning,blood samples were taken to detect the levels of ALT,AST and LDH,histological examination was performed.IVIM-DWI parameters and ADC values were measured by two senior imaging physicians respectively,and the consistency was evaluated by the intraclass correlation coefficient(ICC).One-way analysis of variance(ANOVA)was used to compare the multiple mean difference,the correlation between MRI parameters and biochemical indicators was evaluated using spearman correlation analysis.ResultsThe ICC values of ADC,Dslow,Dfast and PF measured by two physicians were 0.933,0.882,0.692 and 0.839,respectively.The difference of ADC,Dslow,and PF values between T0 group,each warm ischemic group and intervention group was statistically significant(P<0.05).ADC,Dslow,and PF values of the intervention group were significantly higher than those of the corresponding warm ischemia group(P<0.05).ADC,Dslow and PF values were significantly negatively correlated with serum ALT,AST and LDH(r >0.5,P<0.05).The diffuse edema and degeneration of the liver cells,flaky necrosis and hyperplasia of fibrous tissue were observed in warm ischemic group,and the injury degree of the intervention group was reduced compared with that of the corresponding warm ischemic group.Conclusion 3.0 T IVIM-DWI can noninvasively and quantitatively evaluate the protective effect of Lipo-PGE1 on hepatic WIRI.

关 键 词：体素内不相干运动 扩散加权成像 热缺血再灌注损伤 脂质体携载前列腺E1 

分 类 号：R445.2[医药卫生—影像医学与核医学] R575[医药卫生—诊断学]