磁共振弹性成像在家兔肝纤维化分期的实验研究  

Evaluation of Magnetic Resonance Elastography in Staging Hepatic Fibrosis in Experimental Rabbits

作　　者：冯飞[1] 邹立秋[1] 江锦赵[2] 成先义[1] 阮继银[1] 石桥[1] 

机构地区：[1]北京大学深圳医院放射科,深圳518036 [2]香港大学深圳医院,深圳518053

出　　处：《临床放射学杂志》2015年第2期290-293,共4页Journal of Clinical Radiology

基　　金：广东省科技局基金资助项目(编号:2011B031800385)

摘　　要：目的利用家兔肝纤维化模型评价磁共振弹性成像(MRE)在肝纤维化(HF)病理分期中的价值方法建立肝纤维化实验组(n=32)、实验补充组(n=12)、正常对照组(n=15)。对实验组及正常对照兔行常规MRI及MRE检查,测量肝实质的硬度(LS)值。HF组实验兔皮下注射50%CCl4后的第4、5、6、10周分别随机选择8只行MRI扫描。以肝脏纤维化病理组织学诊断为标准,评价第4、5、6、10周MRE与HF病理分期的相关性,并采用ROC曲线分析MRE的诊断准确性。结果不同分期HF的LS值之间存在显著差异(P<0.001),随着HF分期加重,LS值增加。LS与HF分期存在明显相关性(r=0.948,P<0.001)。LS区分各组别HF的敏感性、特异性、准确性、阳性预测值和阴性预测值分别为:≥S1期93.8%、93.3%、93.6%、96.8%、87.5%;≥S2期95.8%、95.7%、95.7%、95.8%、95.7%;≥S3期93.8%、96.8%、95.8%、93.8%、98.8%;S4期100%、97.4%、97.9%、100%、88.9%。结论 MRE作为一种安全、可靠地无创性HF分期技术,可为临床诊治、纵向研究提供一种重要的补充手段。Objective To evaluate magnetic resonance elastography （MRE） in pathologically staging hepatic fibrosis （HF） in experimental rabbits with HF. Methods Experimental models of HF were established in 44 rabbits. The rab- bits were divided into the study group （ n = 32 ） and experimental supplementation group （ n = 12 ）, and other 15 normal rabbits were used as the control group. Conventional MRI and MRE were performed in the rabbits of the study group and the control group to determine the liver hardness value. The rabbits of the study group received subcutaneous injection of 50% CC14 ; at 4, 5, 6 and 10 weeks after the injection MRI scan was separately carried out for randomly-selected 8 rab- bits. Taking histopathological diagnosis as the standard, the correlations between the stages made by MRE and the stages made by pathology at 4, 5, 6 and 10 weeks after the injection were separately evaluated. Using ROC the diagnostic accura- cy of MRE was analyzed. Results Significant differences in liver hardness values existed among different HF stages （ P 〈 0.001 ）. With the aggravation of HF staging, the liver hardness value increased. Significant correlation existed between liv- er hardness and HF staging （r = 0. 948, P 〈 0. 001 ）. The sensitivity, specificity, accuracy, positive （PPV） and negative predictive values （NPV） of liver hardness in distinguishing HF staging for ≥ stage I were 93.8% , 93.3% , 93.6% , 96. 8% and 87.5% respectively; for ≥stage Ⅱ were 95.8%, 95.7%, 95.7%, 95.8% and 95.7% respectively; for ≥ stage Ⅲ were 93.8%, 96.8%, 95.8%, 93.8% and 98.8% respectively; and for stage IV were 100%, 97.4%, 97. 9% , 100% and 88.9% respectively. Conclusion Magnetic resonance elastography is a safe, reliable and non-invasive technique for the staging of hepatic fibrosis. This technique provides an important supplementary means for clinical diagno- sis and treatment of hepatic fibrosis as well as for the research of hepatic fibrosis.

关 键 词：肝纤维化 肝硬化 磁共振弹性成像 硬度 

分 类 号：R575.2[医药卫生—消化系统] R445.2[医药卫生—内科学]