非对比剂增强MR血管成像技术在门静脉成像中的应用  

Application of non-contrast-enhanced MR angiography(NCE-MRA)for imaging of hepatic portal vein

作　　者：汤浩[1] 王秋霞[1] 孟晓岩[1] 王梓[1] 李建军[1] 王艳春[1] 刘小玉[1] 胡军武[1] 胡晓萌[2] 胡道予[1] 

机构地区：[1]华中科技大学同济医学院附属同济医院放射科,武汉430030 [2]武汉市医疗救治中心消化科,武汉430023

出　　处：《放射学实践》2014年第12期1434-1438,共5页Radiologic Practice

基　　金：国家自然科学基金(81271528);湖北省自然科学基金(2013CFB110)

摘　　要：目的:探讨非对比剂增强磁共振血管成像(NCE-MRA)在评估肝脏门静脉解剖中的临床价值,并与MSCT门静脉成像(MSCTP)进行对照。方法:选择30例受试者分别行SLEEK序列NCE-MRA和MSCTA门静脉成像检查,其中肝硬化10例,肝癌10例,健康体检者10例。由两位医师分别对所有患者的NCE-MRA和MSCTP门静脉成像质量进行评分(4级评分法)并进行统计学分析。结果:NCE-MRA组和MSCTP组中,门静脉成像质量评分在2分以上者分别占93.3%(28/30)和96.7%(29/30)。两种方法均能显示所有受试者的3级及3级以下的肝内门静脉,符合率为100%(30/30)。2例(6.7%)健康志愿者的门静脉第6级分支在NCE-MRA上未显示,而在CTP上可以显示;3例(10%)肝硬化门静脉高压患者的门静脉第5级分支在CTP上未显示,而在NCE-MRA上可以显示;2例(6.7%)肝肿瘤患者门静脉的部分第4级分支在CTP上未显示,而在NCE-MRA上可以显示。两种方法的门静脉图像质量评分的差异无统计学意义(P<0.05),两位诊断医师对NCE-MRA门静脉成像质量评分的一致性较高,Kappa值为0.95。结论:SLEEK序列NCE-MRA是一种无需使用对比剂的非侵入性血管成像方法,能有效地对肝脏门静脉进行评估。Objectire：To explore the diagnostic performance of non-contrast-enhanced MR angiography （NCE-MRA） in the anatomic assessment of hepatic portal vein （PV ） using comparative study with multi-slice CT portography （MSCTP）.Methods：Thirty patients including ten patients with hepatic cirrhosis without ascites and ten patients with hepa-tocellular carcinoma and ten healthy volunteers underwent MSCTP and NCE-MRA with SLEEK （spatial labeling with mul-tiple inversion pulses）technique.Imaging quality of hepatic portal veins on NCE-MRA and MSCTP was evaluated and gra-ded with a four-point scale by two radiologists respectively,and the difference of scores between two imaging methods was analyzed with chi-square test.Results：There were 28 cases （28/30,93.3%）with score of image quality more than 2 in NCE-MRA group,and 29 cases （29/30,96.7%）in MSCTP group,respectively.All the segments of PV with grade 1 ～3 were clearly showed both on NCE-MRA and CTP images.Only 2 segments with grade 6 were missed in NCE-MRA group, but were showed in CTP group;and 3 segments with grade 5 and 2 segments with grade 4 were missed in CTP group.There was no statistic difference between the scores of portography in NCE-MRA and CTP group.The agreement of the scores of portography by two radiologist in NCE-MRA group was high with Kappa value （0.95）larger than 0.75.Conclusion：NCE-MRA with SLEEK technique is a non-invasive and effective method which could provide comprehensive assessment of the hepatic portal vein without using contrast medium .

关 键 词：门静脉 肝脏疾病 磁共振成像 血管成像 非对比增强 

分 类 号：R445.2[医药卫生—影像医学与核医学] R543.6[医药卫生—诊断学]