BOLD MRI对兔肝热缺血再灌注损伤及Lipo-PGE1干预作用的评价  

Using blood oxygen level dependent (BOLD) MRI in the diagnosis of hepatic warm ischemia-reperfusion injury in rabbits and evaluation of liposomal prostaglandin E1 intervention effect

作　　者：李婧瑶 褚志强[3] 于文娟[2] 李明阳 任涛[2] 季倩[2] Li Jingyao;Chu Zhiqiang;Yu Wenjuan;Li Mingyang;Ren Tao;Ji Qian(First Central Clinical College, Tianjin Medical University, Tianjin 300070, China;Department of Transplantation, Tianjin First Central Hospital, Tianjin 300192, China;Department of Radiology, Tianjin First Central Hospital, Tianjin 300192, China)

机构地区：[1]天津医科大学第一中心临床学院,300070 [2]天津市第一中心医院放射科,300192 [3]天津市第一中心医院移植科,300192

出　　处：《中华器官移植杂志》2019年第3期175-178,共4页Chinese Journal of Organ Transplantation

基　　金：国家自然科学基金青年基金(81301197);天津市卫计委攻关课题(16KG109);江苏省博士后基金(1601125B).

摘　　要：目的定量评价血氧水平依赖磁共振成像(BOLD MRI)对兔肝不同程度热缺血再灌注损伤(WIRI)的诊断价值及脂质体携载前列腺素E1(Lipo-PGE1)的干预作用评估。方法70只成年、健康新西兰大白兔分组随机分为假手术组(A0组)、不同热缺血时间组(A1~A3组)和相应Lipo-PGE1干预组(A4~A6组),再灌注6 h后行MRI检查,两名影像医生测量计算出各组表观自旋-自旋弛豫率(R2^*)值。检测血清丙氨酸转氨酶(ALT),天冬氨酸转氨酶(AST)、乳酸脱氢酶(LDH)并获取肝脏病理切片。使用单因素方差分析和Spearman相关性分析进行统计,受试者工作曲线(ROC)分析R2^*值的诊断效能。结果两名测量者之间组内相关素数(ICC)=0.805,可重复性好。单因素方差分析显示,R2^*值在假手术组、热缺血组、干预组之间总体比较差异有统计学意义(P<0.05)。假手术组与各热缺血组之间比较差异有统计学意义(P<0.05),随着热缺血时间延长,R2^*值升高;假手术组与各干预组之间比较差异有统计学意义(P<0.05),假手术组、相同时间热缺血组及干预组之间比较差异有统计学意义(P<0.05),干预组与对应热缺血组比较R2*值均减低,热缺血时间越长,减低程度越明显,但未达到正常组水平。R2^*值与ALT、AST和LDH间呈显著正相关(r>0.5,P<0.05)。ROC分析R2*值诊断效能好。结论BOLD MRI可无创、定量、动态评价不同程度的肝热缺血再灌注损伤;Lipo-PGE1能减轻肝热缺血再灌注损伤,BOLD MRI可无创、定量评价其缓解程度。Objective To quantitatively evaluate the diagnostic value of blood oxygen level-dependent (BOLD) MRI in the diagnosis of different degrees of liver warm ischemia-reperfusion injury (WIRI) in rabbits and evaluate the intervention effect of liposomal prostaglandin E1 (Lipo-PGE1). Methods Seventy healthy adult New Zealand white rabbits were randomly divided into sham-operated group (A0), thermal ischemic groups (A1~A3) and intervention groups (A4~A6). All experimental rabbits were scanned by routine MR and BOLD MRI after 6-hour reperfusion. R2^* images were calculated by two radiologists. The levels of alanine aminotransferase (ALT), asparate aminotransferase (AST) and lactate dehydrogenase (LDH) were examined. And liver pathological sectioning was performed. All data were processed by one-way, Spearman’s correlation and receiver operating characteristic curve analyses. Results The intraclass correlation coefficient (ICC) was 0.805 of two measurements suggesting that the repeatability of the outcome was decent. R2^* values among sham-operated, thermal ischemia and intervention groups were statistically significant (P<0.05). R2* values in sham-operated and ischemia groups were statistically significant (P<0.05). As warm ischemia time elapsed, R2^* value showed a rising trend. R2^* values in sham-operated and intervention groups were statistically significant (P<0.05). R2* values of sham-operated group at the same timepoint of thermal ischemia and intervention groups were statistically significant (P<0.05). Under the same ischemic time, R2^* values of intervention groups were smaller than those of thermal ischemia groups. With the prolongation of ischemia time, reduction of R2^* values became more pronounced. However, it did not reach the level of A0 group. R2^* values were significantly positively correlated with ALT, AST and LDH (r>0.5, P<0.05). ROC analysis indicated that R2^* had an excellent diagnostic performance. Conclusions BOLD MRI may be applied for noninvasive assessment of liver ischemia-reperfusion inju

关 键 词：磁共振成像 肝 缺血再灌注损伤 

分 类 号：R657.3[医药卫生—外科学]