Gd-EOB-DTPA动态增强MRI定量评估兔肝纤维化分期的实验研究  

Quantitative experimental study in a rabbit model of liver fibrosis by DCE-MRI with Gd-EOB-DTPA

作　　者：江锦赵 邹立秋 张豪 钟文新[2] 程琳 沈新平 杨洋 JIANG Jinzhao;ZOU Liqiu;ZHANG Hao;ZHONG Wenxin;CHENG Lin;SHEN Xinping;YANG Yang(Department of Medical Imaging Center,the University of Hong Kong-Shenzhen Hospital,Shenzhen 518053,China;Department of Medical Imaging,Huazhong University of Science and Technology Union Shenzhen Hospital,Shenzhen 518052,China)

机构地区：[1]香港大学深圳医院医学影像科,深圳518053 [2]华中科技大学协和深圳医院放射科,深圳518052

出　　处：《磁共振成像》2021年第6期66-71,共6页Chinese Journal of Magnetic Resonance Imaging

基　　金：国家自然科学基金面上项目(编号:81771805);深圳市南山区重点科技项目(编号:2018009)。

摘　　要：目的探讨钆塞酸二钠(Gd-EOB-DTPA)动态增强扫描(dynamic contrast-enhanced magnetic resonance imaging,DCE-MRI)定量评估兔肝纤维化(liver fibrosis,LF)分期的价值。材料与方法选取正常纯种新西兰大白兔,采用皮下注射50%四氯化碳油溶液构建LF组(n=118)、对照组(n=40),在注射第4、5、6、15周末进行LF组和对照组兔肝脏轴位扫描T1WI及DCE-MRI扫描,测量并计算各定量参数:容积转运常数(K^(trans))、返流速率常数(K_(ep))、血管外细胞外间隙容积分数(V_(e))、血浆容积分数(V_(p)),扫描后取肝组织进行病理Scheuer纤维化分期。共获得肝纤维化模型组(LF组,n=118)和对照组(n=32),采用单因素方差分析评价不同LF分期组间各定量参数的差异,采用Spearman法分析各定量参数与LF病理分期的相关性,绘制ROC曲线比较各参数对诊断LF分期的价值。结果150只兔纳入本研究,F0期32只,F1期32只,F2期35只,F3期30只,F4期21只。K^(trans)在F0与F2、F3、F4组,F1与F2、F3、F4组,F2与F4组间差异有统计学意义(P<0.05);F3组与F4组差异无统计学意义。K_(ep)在F0组与F2、F3、F4组间,F1组与F2、F3、F4组间差异有统计学意义(P<0.05);V_(p)在F1与F0、F2、F3、F4组间差异有统计学意义(P<0.05);而各组间Ve差异无统计学意义(P>0.05)。K^(trans)与LF分期呈正相关(r=0.730,P<0.0001);K_(ep)与LF分期呈负相关(r=-0.617,P<0.0001);V_(e)、V_(p)与LF分期间无相关性(P>0.05)。ROC曲线显示K^(trans)诊断效能最高,在诊断F0 vs.F1F4、F0 vs.F1F2、F0vs.F3F4、F1F2 vs.F3F4的AUC分别为0.897、0.863、0.942、0.809;而K_(ep)相应AUC分别为0.820、0.787、0.864、0.768。结论Gd-EOB-DTPA DCE-MRI定量评估对肝纤维化分期具有明确的诊断价值,其中K^(trans)显示出最佳的诊断效能,K_(ep)次之。Objective:To explore the diagnostic performance of dynamic contrast-enhanced magnetic resonance imaging with(DCE-MRI),which based on pharmacokinetics,for quantitatively evaluating the stage of liver fibrosis(LF)in rabbits.Materials and Methods:Two hundred healthy rabbits were randomly divided into LF group(n=118)and control group(n=40).LF group received subcutaneous injection of 50%CCl4 oil solution,while control group received injection with the same amount of normal saline solution.The LF group(n=40)and control group(n=10)were randomly selected at the end of the 4th,5th,6th,15th week,respectively.All selected rabbits were underwent MRI axial scan for quantitative characteristic parameter values,including volume transfer constant(K^(trans)),reflux rate constant(K_(ep)),volume fraction of extravascular extracellular space(V_(e))and volume fraction of plasma(V_(p)).All the liver tissue were sampled for the histopathological Scheuer staging.One-way analysis of variance evaluated the differences of K^(trans),K_(ep),Ve and Vp among different groups.Spearman correlation was used to analyze the correlation between K^(trans),K_(ep),Ve and Vp in different LF stages.Comparing the diagnostic performance of all quantitative parameter values by ROC curve analysis.Results:There were 150 rabbits included in our study,which covered F0(n=32);F1(n=32);F2(n=35);F3(n=30)and F4(n=21).Significant differences of K^(trans) were demonstrated between F0 vs.F2,F3,F4,respectively;F1 vs.F2,F3,F4,respectively;F2 vs.F4(P<0.05).There were significant differences in K_(ep) between F0 vs.F2,F3,F4,respectively;F1 vs.F2,F3,F4,respectively(P<0.05).There were significant differences in Vpbetween F1 vs.F0,F2,F3,F4,respectively(P<0.05).But no significant differences of V_(e) were shown among all groups(P>0.05).K^(trans)and K_(ep) were correlated with LF stage(r=0.730,-0.617,respectively,P<0.0001),whereas,no significant correlation was found for V_(e) or Vp(P>0.05).The AUCs of K^(trans) were the greatest than those of the other quantitative parameters(

关 键 词：肝纤维化 磁共振成像 动态增强扫描 容积转运常数 返流速率常数 

分 类 号：R445.2[医药卫生—影像医学与核医学] R332[医药卫生—诊断学]