IVIM评价兔肠系膜动脉栓塞致急性肠系膜缺血的实验研究  

Experimental study of IVIM evaluating acute mesenteric ischemia induced by mesenteric artery embolization in rabbits

作　　者：巴成慧 王鑫雨 许昌[1] 陈亮[1] 钟晓飞 曹璋[2] 张迪鸣 张濬韬 姜兴岳[1] BA Chenghui;WANG Xinyu;XU Chang;CHEN Liang;ZHONG Xiaofei;CAO Zhang;ZHANG Diming;ZHANG Juntao;JIANG Xingyue(Department of Radiology,Affiliated Hospital of Binzhou Medical University,Binzhou 256600,China;Department of Pathology,Affiliated Hospital of Binzhou Medical University,Binzhou 256600,China;GE Healthcare Shanghai Co.,Ltd.,Precision Health Institution,Shanghai 210000,China)

机构地区：[1]滨州医学院附属医院放射科,滨州256600 [2]滨州医学院附属医院病理科,滨州256600 [3]通用电气药业(上海)有限公司,上海210000

出　　处：《磁共振成像》2022年第5期82-88,共7页Chinese Journal of Magnetic Resonance Imaging

基　　金：山东省自然科学基金(编号:ZR2018LH015)。

摘　　要：目的探讨3.0 T磁共振体素内不相干运动(intravoxel incoherent motion,IVIM)扩散加权成像定量评估兔急性肠系膜缺血(acute mesenteric ischemia,AMI)的价值。材料与方法以66只新西兰兔为研究对象,将其随机分为实验组和假手术组,每组33只,每组分为11个时间节点,每时间节点3只。实验组开腹结扎前肠系膜动脉主干建立AMI模型,假手术组仅开腹、不结扎。使用3.0 T MR行IVIM检查,扫描结束后进行病理标本采集及制作。对影像图像进行后处理获得IVIM参数值(f值、D值、D*值)。使用单因素方差分析对实验组与假手术组之间各参数值的差异进行比较。将影像结果与病理结果进行比较。结果以病理结果为金标准,当肠系膜缺血2 h左右时,实验组f值和D值低于假手术组(D值约<1.0×10-3mm2/s,f值约<0.3),差异有统计学意义(P<0.05),D*值实验组及假手术组差异无统计学意义(P>0.05),病理结果显示此时缺血仅累及肠壁黏膜层。当肠系膜缺血达到4.5 h左右时,f值及D值进一步降低(D值约<1.0×10-3mm2/s,0<f值<0.1),D*值降低,各参数值差异有统计学意义(P<0.05),此时病理结果显示肌层受累。当肠缺血时间达到5.5 h时,f值近似于0,D值升高(约>1.0×10-3mm2/s),D*值较前大致相同,D值及D*值在实验组与假手术组间差异无统计学意义(P>0.05),此时缺血肠壁结构破坏严重甚至累及肠壁全层。结论IVIM定量参数中f值及D值能够反映微循环障碍的病理生理过程,与病理具有良好的相关性,有助于AMI的早期定量评估与动态监测,为临床评价AMI提供理论依据。Objective:To quantitatively evaluate the early signs and dynamic evolution of acute mesenteric ischemia(AMI) by 3.0 T magnetic resonance intravoxel incoherent motion(IVIM) diffusion weighted imaging.Materials and Methods:Sixty-six New Zealand rabbits were selected as research subjects and randomly divided into experimental group and control group,including 11 time nodes(1 h,1.5 h,2 h,2.5 h,3 h,3.5 h,4 h,4.5 h,5 h,5.5 h,6 h),33 rabbits in each group,3 rabbits in each time node.Acute intestinal ischemia model was established in the experimental group before ligation of the main mesenteric artery,while in the control group,only ligation was performed.IVIM examination was performed on 3.0 T MR,and pathological specimens were collected and made after the scanning.The IVIM parameters were obtained by post-processing the image.One-way ANOVA was used to compare the differences of parameters between the experimental group and the control group.The imaging results were compared with pathological results to analyze the quantitative evaluation value of IVIM in acute intestinal ischemia.Results:Using pathological results as the gold standard,when mesenteric ischemia occurred for about 2 hours,the f and D values of the experimental group were lower than those of the sham operation group(D value<1.0×10-3mm2/s,f value<0.3),the difference was statistically significant(P<0.05),but there was no significant difference between the experimental group and the sham operation group(P>0.05).Pathological results showed that only intestinal wall mucosa was affected by ischemia at this time.When mesenteric ischemia reached 4 h,f value,D value and D*value were significantly different between the experimental group and the sham operation group(P<0.05).When mesenteric ischemia reached about 4.5 h,the f value and D value further decreased(D value<1.0×10-3mm2/s,0<f value<0.1),and the D*value decreased,with statistical significance(P<0.05).At this time,the pathological results showed muscle layer involvement.When mesenteric ischemia time reached

关 键 词：急性肠系膜缺血 磁共振成像 体素内不相干运动 新西兰兔 早期诊断 

分 类 号：R445.2[医药卫生—影像医学与核医学] R-332[医药卫生—诊断学]