三维全肝MRI动态增强扫描定量分析在肝脏肿瘤诊断中的应用  

The application of the quantitative analysis of three-dimensional whole-liver DCE-MRI in the diagnosis of hepatic tumors

作　　者：徐运军[1] 程慧敏[1] 翟羽佳[1] 陆杨[2] XU Yun-jun CHENG Hui-min ZHAI Yu-jia LU Yang(Deptartment of Radiology,Anhtti Provincial Hospital, Hefei Anhui 230001 School of Chemistry and Chemical Engineering, Hefei University of Technology, Hefei Anhui 230009, China)

机构地区：[1]安徽省立医院影像科,安徽合肥230001 [2]合肥工业大学化学与化工学院,安徽合肥230009

出　　处：《蚌埠医学院学报》2016年第9期1230-1234,共5页Journal of Bengbu Medical College

基　　金：国家自然科学基金青年科学基金项目(21501039);安徽省卫生厅临床医学应用技术项目(2008B039)

摘　　要：目的：研究肝细胞肝癌（HCC）、肝转移瘤（HM）和肝血管瘤（HH）患者的肝动脉灌注指数（HPI）以及血管渗透性参数,探讨三维全肝MRI动态增强扫描定量分析在鉴别诊断肝脏肿瘤中的价值。方法：选取58例受检者（HCC组30例,HM组16例,HH组12例）,采用三维容积内插体部检查（VIBE）序列进行全肝磁共振动态增强扫描（DCE-MRI）,并用Omni-Kinetics软件分析图像,结合肝脏双输入血流动力学模型获得肝脏灌注和血管渗透性参数HPI、容积转运常数（Ktrans）、回流速率常数（kep）、血管外细胞外间隙体积比（ve）值和血浆空间容积率（vp）。结果：3组HPI值、Ktrans和kep值差异均有统计学意义（P〈0.05~P〈0.01）;HPI值HCC组〉HH组〉HM组（P〈0.05）;Ktrans值HCC组〉HH组〉HM组（P〈0.05~P〈0.01）;kep值HCC组〉HH组和HM组（P〈0.01）,但HH组和HM组的kep值差异无统计学意义（P〉0.05）;3组ve和vp值差异均无统计学意义（P〉0.05）。结论：三维全肝DCE-MRI扫描可获得定量血流灌注及血管渗透性参数,有助于肝脏肿瘤的鉴别诊断。Objective：To investigate the hepatic perfusion index（HPI） and vascular permeability parameters in patients with different hepatic tumors, which included hepatoeellular carcinoma （ HCC ）, hepatic metastasis （ HM ） and hepatic haemangiomas （ HH ）, and discuss the clinical diagnosis value of DCE-MRI. Methods：Fifty-eight patients with hepatic tumors （30 cases of HCC, 16 cases of HM and 12 cases HH） were detected by the 3D whole-liver dynamic contrast enhance MRI（DCE-MRI） using volumetric interpolated body examination （VIBE） sequence. The perfusion and vascular permeability parameters （including HPI, Ktrans, kep, ve and vp ） were measured by the Omni-Kinetics software combined with liver model of dual input hemodynamics. Results：There was statistical difference in the values of HPI,Ktrans and kep between three groups（P 〈0.05 to P 〈0. 01 ）. The HPI value in HCC group was significantly higher than that in HH group, and the HPI value was the lowest in HM group （ P 〈 0.05 ）. The Ktrans value in HH group was significantly lower than that in HCC group,and the value was the lowest in HM group（P 〈0.05 to P 〈0.01 ）. The kep value in HCC group was higher than that in HH and HM groups （P 〈 0.01 ） , but there was no statistical difference between HH and HM groups （ P 〉 0.05 ）. The differences of the vp and ve values between three groups were not statistically significant （ P 〉 0.05 ）. Conclusions ： Three-dimensional whole-liver DCE-MRI with the bolus injection of gadodiamide can be used to quantify the perfusion and permeability parameters of hepatic tumors, which is benefit to the differentiation diagnosis of hepatic tumors.

关 键 词：肝肿瘤 磁共振成像 肝脏 动态增强 

分 类 号：R735.7[医药卫生—肿瘤]