3.0 T MRI动态增强评估肝纤维化分期的实验研究  

Evaluation of Staging of Hepatic Fibrosis by 3.0T DCE-MRI-An Experimental Study

作　　者：李坤芳[1] 廖锦元[1] 阳腾飞 苏文[1] 谢雨恩 LI Kunfang;LIAO Jinyuan;YANG Tengfei(Department of Radiology, No. 1 Affiliated Hospital of Guangxi Medical University, Nanning, Guangxi Zhuang Autonomous Region 530021, P. R. China)

机构地区：[1]广西医科大学第一附属医院放射科

出　　处：《临床放射学杂志》2018年第4期711-715,共5页Journal of Clinical Radiology

基　　金：国家自然科学基金项目(编号:81360220);广西自然科学基金项目(编号:2010GXNSFA013189)

摘　　要：目的探讨3.0 T磁共振动态增强定量参数评估肝纤维化分期的可行性。方法家兔40只,随机分为实验组30只,对照组10只;实验组采用四氯化碳腹腔注射法建立肝纤维化模型,对照组清水及饲料喂养。于造模第6、8、10、12、16周末对兔行3.0 T磁共振动态增强扫描,获得肝脏定量灌注参数：K^trans、Kep、Ve。扫描结束后取肝组织行肝纤维化病理分期。统计学分析不同肝纤维化分期的MRI参数差异,各定量参数与肝纤维化分期的相关性,ROC曲线判别各参数诊断不同级别肝纤维化的敏感性和特异性,P〈0.05为差异有统计学意义。结果实验结束获取肝纤维化F0-F4分别为：10、8、7、9、6例。F0-F4,K^trans、Kep逐渐减低,组间有统计学差异（P〈0.05）;Ve逐渐增加,组间没有统计学差异（P〉0.05）。K^trans、Kep值在F0 vs F1-4、F0-2 vs F3-4组间差异有统计学意义（P〈0.05）。K^trans、Kep与肝纤维化分期呈负相关（r=-0.739、-0.530,P〈0.005）,Ve与肝纤维化分期呈正相关（r=0.306,P〈0.05）。ROC曲线分析,K^trans值对判别F0 vs F1-4、F0 vs F1-2、F0 vs F3-4、F0-2 vs F3-4的ROC曲线下的面积分别为0.878、0.770、0.967、0.898;Kep均值对判别F0 vs F1-4、F0 vs F1-2、F0 vs F3-4、F0-2 vs F3-4的ROC曲线下的面积分别为0.699、0.563、0.810、0.820。结论 3.0 T磁共振定量参数K^trans、K_（ep）可鉴别正常肝脏与肝纤维化,也有助于鉴别轻度-重度肝纤维化。Objective To investigate the feasibility of dynamic quantitative parameters of 3. 0 T magnetic resonance in assessing liver fibrosis staging. Methods Forty rabbits were randomly divided into experimental group（ n = 30） and control group（ n = 10）. The experimental group was treated with intraperitoneal injection of carbon tetrachloride to establish hepatic fibrosis model,and the control group was treated with clear water and feed. At the end of the 6 th,8 th,10 th,12 th,and 16 th week of modeling,rabbits underwent a 3. 0 T magnetic resonance dynamic contrast-enhanced scan to obtain quantitative liver perfusion parameters： K^trans,Kep,and Ve. After the end of the scan,the liver tissue was taken for pathological staging of hepatic fibrosis. Statistical analysis of differences in MR parameters of different stages of liver fibrosis,correlation of quantitative parameters with liver fibrosis stages,and ROC curves to discriminate the sensitivity and specificity of each parameter in diagnosing different grades of liver fibrosis,P〈0. 05 statistically significant. Results 1. At the end of the experiment,liver fibrosis F0 - F4 were obtained： 10,8,7,9 and 6 cases respectively. 2. F0 - F4,K^trans,and Kepgradually decreased,with statistical differences between the groups（ P〈0. 05）; Vegradually increased,and there was no statistical difference between the groups（ P〈0. 05）. K^transand Kepvalues were significantly different between F0 vs F1 - 4,F0- 2 vs F3 - 4 groups（ P〈0. 05 The difference of K^trans,Kepin F0 vs F1-4、F0-2 vs F3-4 were statistically significant（ P〈0. 05）. 3,K^trans,Kepwere negative correlation with liver fibrosis staging（ r =-0. 739,r =-0. 530,P〈0. 005）,Ve showed positive correlation with liver fibrosis staging（ r = 0. 306,P〈0. 05）. 4、Using ROC analysis,the area under curve（ AUC） for identifying F0 vs F1-4、F0 vs F1-2、F0 vs F3-4、F0-2 vs F3-4 were 0. 878、0. 770、0. 967 and 0. 898 respectively by K^trans,the AUC for identifying F0 vs F1-4、F0 vs F1-2�

关 键 词：磁共振动态增强 定量参数 肝纤维化 动物模型 病理 

分 类 号：R445.2[医药卫生—影像医学与核医学] R575.2[医药卫生—诊断学]