胆道梗阻患者基于磁共振弹性成像上的肝脏硬度值分析  

An analysis of liver elasticity based on MR elastography in patients with biliary obstruction

作　　者：王怡鑫 石喻[1] 郭启勇[1] WANG Yi-xin;SHI Yu;GUO Qi-yong(Department of Radiology,Shengjing Hospital of China Medical University,Shenyang 110004,China)

机构地区：[1]中国医科大学附属盛京医院放射科,辽宁沈阳110004

出　　处：《中国临床医学影像杂志》2021年第4期267-271,共5页Journal of China Clinic Medical Imaging

基　　金：国家自然科学基金(81771893)。

摘　　要：目的:采用3.0TM磁共振弹性成像评估胆道梗阻患者和非胆道梗阻患者肝脏硬度值的差异,分析肝脏硬度值和血清标志物及致病因素的相关性,并探讨胆道引流术前后肝脏硬度值的变化。方法:80例无肝病病史的患者被包括在本回顾性研究中,通过胆红素及胆总管直径测定,将其分为39例梗阻性患者(A组)和41例非梗阻性患者(B组),通过独立样本t检验比较A、B两组的肝脏硬度值、实验室数据间的差异;皮尔逊相关系数分析肝脏硬度值与实验室数据的相关性;分析致病因素良恶性对肝脏硬度值的影响。对行胆道引流术的20例A组患者手术前后的肝脏硬度值进行独立样本t检验分析。结果:(1)A、B两组患者除致病因素外基本特征无差异。(2)A组肝脏硬度值((4.45±1.03)kPa)明显高于B组((2.27±0.36)kPa),P<0.01。(3)肝脏硬度值与胆道梗阻程度呈正相关。(4)致病因素无论是恶性还是良性,均为胆道梗阻组患者的肝脏硬度值高于非梗阻组。(5)20例A组患者行胆道引流术后弹性值显著降低(P<0.01)。结论:磁共振弹性成像测量的肝脏硬度值与胆道梗阻程度呈正相关,与致病因素良恶性无关。胆道梗阻患者胆道引流术后肝脏硬度值明显减低,这种肝脏硬度值增加是一种可逆的病变进程。Objective:3.0 T magnetic resonance elastography was used to evaluate the difference in liver hardness between patients with biliary obstruction and non-biliary obstruction,and to analyze the correlation between liver hardness value and serum markers,as well as the correlation of pathogenic factors.To investigate the changes of liver hardness value before and after biliary drainage.Methods:In this retrospective study,80 patients with no history of liver disease were included.By measuring bilirubin and common bile duct diameter,they were divided into 39 obstructive patients(group A)and 41 non-obstructive patients(group B).Independent sample t-test was used to compare the liver hardness value and laboratory data between the two groups.And Pearson correlation coefficient to analyze the correlation between liver hardness value and laboratory data.The influence of benign and malignant factors on the elasticity of liver was analyzed.And independent sample t-test was performed to analyze the liver hardness values of 20 patients in group A before and after biliary drainage.Results:(1)There was no difference in the basic characteristics except the pathogenic factors of patients in group A and group B.(2)The liver hardness of group A((4.45±1.03)kPa)was significantly higher than group B(2.27±0.36)kPa),P<0.01.(3)Liver hardness was positively correlated with the degree of biliary obstruction.(4)Whether malignant or benign,liver hardness of patients in the biliary obstruction group was higher than that in the non-obstruction group.(5)The elasticity value of 20 patients in group A was significantly reduced after biliary drainage(P<0.01).Conclusion:The hardness of liver measured by MR elastography was positively correlated with the degree of biliary obstruction,but not with the pathogenic benign and malignant factors.In patients with biliary obstruction,liver hardness is significantly reduced after biliary drainage,and this increase in liver hardness is a reversible process.

关 键 词：胆汁淤积 磁共振成像 

分 类 号：R657.43[医药卫生—外科学] R445.2[医药卫生—临床医学]