3.0 T磁共振相位对比法定量肝硬化门静脉血流动力学与肝功能状况的相关性研究  

The Relationship between the Portal System Hemodynamics Determined by 3. 0 T PC-MRI and Liver Function in Cirrhosis Patients

作　　者：殷鑫[1] 袁肖娜 陈勇[2] 高知玲[2] 朱凯[2] 马彩花 郭玉林[2] 

机构地区：[1]宁夏医科大学,银川750004 [2]宁夏医科大学总医院放射科,银川750004

出　　处：《临床放射学杂志》2015年第4期567-571,共5页Journal of Clinical Radiology

基　　金：国家自然科学基金项目(编号:61061005;61440043)

摘　　要：目的运用磁共振相位对比法（PC-MRI）对门静脉系统血流参数进行测量,探讨PC-MRI在乙肝肝硬化肝功能状况评价中的应用价值及意义。方法 40例乙肝肝硬化患者,男32例,女8例,年龄29-70岁,平均52.3岁,其中Child-Pugh A级15例,B级13例,C级12例;10例对照组患者,男6例,女4例,年龄40-60岁,平均42岁。通过PC-MRI测量门静脉、肠系膜上静脉及脾静脉的截面积（S,mm^2）、平均血流量（Q,ml/s）和平均流速（V,cm/s）。结果对照组门静脉截面积（SPV）明显小于肝硬化各组（P〈0.05）;随着肝硬化程度的加重,门静脉平均血流量（QPV）和平均流速（VPV）逐渐减小（P〈0.05）,Child-Pugh C级的VPV明显低于Child-Pugh A、B级（P〈0.05）;肝硬化各组肠系膜上静脉截面积（SSMV）明显高于正常组（P〈0.05）,Child-Pugh B级低于Child-Pugh A、C级（P〈0.05）;Child-Pugh B、C级SSV较正常组明显增大,且差异具有统计学意义（P〈0.05）。QPV、VPV、脾静脉平均血流量（QSV）和脾静脉平均流速（VSV）与MELD评分呈负相关（P〈0.05）,相关系数分别为-0.396、-0.464、-0.453、-0.549。结论 PC-MRI可有效评价乙肝肝硬化不同肝储备功能状态的门静脉系统血流状态,是评价肝硬化严重程度及肝脏储备功能的重要影像学手段。Objective To measure portal flow parameters by using phase-contrast magnetic resonance imaging （PC- MRI） in order to investigate the value of PC-MRI in assessing the liver function in patients with cirrhosis. Methods A total of 40 patients with hepatitis B cirrhosis （ study group） , including 32 males and 8 females with a mean age of 52.3 years （29 -70 years）, were included in this study. Of the 40 patients, Child-Pugh class A was seen in 15, class B in 13 and class C in 12. Other 10 patients who had no liver diseases, including 6 males and 4 females with a mean age of 42 years （40 -60 years）, were collected as the control group. PC-MRI was performed in all patients. The cross-sectional area （ S, mm^2 ）, the mean flow volume （ Q, ml/min） and the mean velocity （ V, cm/s） of the portal vein （ PV）, superior mesenteric vein （ Suv ） and splenic vein （SV） were calculated. Results Spy of the control group was significantly lower than that of the cirrhosis group （P 〈 0.05 ）. With the aggravation of liver cirrhosis degree, QPv and Vpv gradually decreased （ P 〈 0.05 ）. Vpv in Child-Pugh class C was obviously lower than that in Child-Pugh class A as well as in Child-Pugh class B （ P 〈 0.05 ）. Ssuv of the study group, regardless of the Child-Pugh classifications, was significantly higher than that of the control group （ P 〈 0.05 ）. In the study group, SSMv of Child-Pugh class B was significantly lower than that of Child-Pugh class A and C （ P 〈 0.05 ）. Ssv of Child-Pugh class B and C was larger than that of the control group, and the difference was statistically significant （ P 〈 0.05 ）. The flow parameters, including Qpv, Vpv Qsv and Vsv, bore a negative correlation with MELD score, the correlation coefficients being - 0. 396, - 0. 464, - 0. 453, - 0. 549 respectively （ P 〈 0.05 ）. Conclusion PC-MRI can effectively evaluate the hemodynamic state of portal vein system in hepatitis B cirrhosis patients with different liver reserve function. Ther

关 键 词：相位对比磁共振成像 肝硬化 CHILD-PUGH分级 MELD评分 

分 类 号：R575.2[医药卫生—消化系统]