3.0T BOLD MRI在评价兔肝热缺血再灌注损伤中的应用价值  

Applied value of 3. 0T blood oxygen level dependent （BOLD） MRI in the diagnosis of hepatic warm ischemia-reperfusion injury （WIRI） in rabbits

作　　者：许诗超 褚志强[2] 任涛[2] 谢双双[2] 谭志军[2] 季倩[2] 

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

出　　处：《中华器官移植杂志》2016年第2期112-116,共5页Chinese Journal of Organ Transplantation

基　　金：国家自然科学基金（81301197）;天津市卫生局科技基金（2013ZK023）

摘　　要：目的探讨3．0T血氧水平依赖核磁共振成像（BOLD MRI）对兔肝热缺血再灌注损伤的诊断价值。方法健康成年新西兰大白兔20只，采用随机数字表法将兔分为对照组及实验组，每组10只。实验组兔夹闭肝动脉和门静脉30min，以及再灌注6h建立肝热缺血再灌注损伤模型，对照组兔不施行任何手术，在麻醉后即进行相关检测。所有实验兔行常规3．0TMRI扫描和BOLD MRI检查，由2位资深影像学医师分别测量兔肝T2＊值，并计算R2＊（R2＊=1／T2＊）值，使用组内相关系数（ICC）检验其一致性。于MRI检查后，经耳缘静脉采集两组兔外周血检测血清天冬氨酸转氨酶（AST）、丙氨酸转移酶（ALT）和乳酸脱氢酶（LDH）；取冻存肝组织检测其超氧化物歧化酶（SOD）、丙二醛（MDA）及髓过氧化物酶（MPO），并取肝组织进行组织病理学检查。应用Spearman相关分析评价R2＊值与各检测指标间的相关性，应用ROC曲线评价R2＊值诊断效能。结果两次测量结果ICC=0．87〉0．75，表明可重复性较好；实验组兔肝的R2＊值显著高于对照组兔肝R2＊值（P=0．000）；实验组ALT、AST、LDH、MDA及MPO均显著高于对照组，实验组总SOD显著低于对照组，两组间比较，差异均具有统计学意义（P〈O．01）。R2＊值与ALT、AST、LDH、MDA及MPO间均呈显著正相关（r〉O．6，P〈O．05），R2＊值与SOD间呈显著负相关（r=-0．663，P=0．001）。R2＊值评价兔肝热缺血再灌注损伤具有较高的诊断效能（AUC=0．99），其最佳诊断阈值为116．40Hz。结论3．0T BOLD MRI能准确、无创评价肝热缺血再灌注损伤所致的病理生理变化，对动态监测及评价肝热缺血-再灌注损伤具有重要临床意义。Objective To investigate the applied value of 3. 0T blood oxygen level dependent （BOLD） MRI in the diagnosis of hepatic warm ischemia-reperfusion injury （WIRI） in rabbits. Method Twenty healthy adult New Zealand white rabbits were randomly divided into two groups by using the stochastic indicator method. In 10 rabbits enrolled in the treatment group, the model of hepatic WIRI after ischemia for 30 min followed by 6-h reperfusion was established, and the remaining 10 rabbits were chosen as the normal control group and were not subjected to any surgery. All the experimental rabbits were scanned by 3. 0T MRI and BOLD MRI. T2＊ values were separately measured by 2 considered radiologists and the R2＊ values were calculated （R2＊ = 1/T2＊ ）. Thereafter, the intra-class correlation coefficient （ICC） was used to check the consistency. All rabbits were killed after MR examination and routine assays were performed for testing the levels of alanine aminotransferase （ALT）, aspartate aminotransferase （AST）, and lactate dehydrogenase （LDH） in the ear vein blood serum. The contents of total superoxide dismutase （SOD）, malondialdehyde （MDA） and myeloperoxidase （MPO） in liver tissues were determined, and histopathological changes were examined. The correlation between R2 ＊ value and clinical test index was evaluated by Spearman correlation analysis. The R2＊ value was evaluated by ROC curve. Result ICC = 0. 87 〉 0. 75, suggesting that the repeatability of the outcome is good. Compared to the normal control group, R2＊ value of the warm ischemia-reperfusion injury group was increased （P = 0. 000）. The differences in ALT, AST, LDH, total SOD, MDA and MPO between the two groups were statistically significant （P〈0. 01 ）. R2＊ values were significantly positively correlated with ALT, AST, LDH, MDA and MPO （r〉0. 6, P〈0. 05）, and there was a significantly negative correlation between R2＊ and total SOD （r= - 0. 663, P = 0. 001）. The R2＊ value could efficien

关 键 词：兔 肝 缺血再灌注损伤 BOLD MRI 

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