磁共振弥散张量成像对兔肝缺血再灌注损伤晚期阶段肝损伤程度的评估价值  

Value of Magnetic Resonance Diffusion Tensor Imaging in Evaluation of the degree of Liver Injury in Late Stage of Hepatic Ischemia-reperfusion Injury in Rabbits

作　　者：郭成伟 郝永 张小燕[4] 金正印 崔现成 王红素 张宝华 吴清华 颜林军 GUO Cheng-wei;HAO Yong;ZHANG Xiao-yan;JIN Zheng-yin;CUI Xian-cheng;WANG Hong-su;ZHANG Bao-hua;WU Qing-hua;YAN Lin-jun(Department of Medical Imaging,the Hospital of 82 PLA Army Group,Baoding,Hebei 071000,China;Department of Quality Control,the Hospital of 82 PLA Army Group,Baoding,Hebei 071000,China;the First Department of Imaging,the First Central Hospital of Baoding City,Baoding,Hebei 071000,China;Department of Radiology,Baoding Children's Hospital,Baoding,Hebei 071000,China;Department of General Internal Medicine,Jinxi Medical District of PLA General Hospital,Beijing 100041,China)

机构地区：[1]解放军陆军第八十二集团军医院医学影像科,河北保定071000 [2]解放军陆军第八十二集团军医院质量管理科,河北保定071000 [3]保定市第一中心医院总院影像一科,河北保定071000 [4]保定市儿童医院放射科,河北保定071000 [5]解放军总医院京西医疗区综合内科,北京100041

出　　处：《临床误诊误治》2022年第6期114-118,共5页Clinical Misdiagnosis & Mistherapy

基　　金：河北省医学科研计划项目(20210445);保定市科技计划项目(1951ZF106)。

摘　　要：目的观察兔肝缺血再灌注损伤(IRI)晚期阶段弥散张量成像(DTI)参数平均扩散系数(DCavg)和各向异性系数(FA)变化情况及与天冬氨酸转氨酶(AST)、丙氨酸转氨酶(ALT)、血清肿瘤坏死因子-α(TNF-α)、镜下病理组织学积分的相关性。方法24只实验兔,将其中18只制成IRI模型,随机分为IRI 12 h、IRI 24 h和IRI 48 h组,每组6只,假手术组6只。各组分别行磁共振DTI(b=100、300、600 s/mm^(2))检查,检测AST、ALT及TNF-α水平,评估病理形态学积分。采用多元线性相关分析血清AST、ALT、TNF-α水平及病理形态学积分与DCavg、FA间相关性。结果4组AST、ALT、TNF-α水平及病理形态学积分比较差异有统计学意义(P<0.05)。b=100 s/mm^(2)时,IRI 24 h组DCavg低于假手术组(P<0.05);b=100、300、600 s/mm^(2)时,IRI 48 h组DCavg高于IRI 24 h组(P<0.05)。b=300、600 s/mm^(2)时,IRI 24 h组FA低于假手术组,IRI 48 h组FA低于假手术组及IRI 12 h、24 h组(P<0.05)。DCavg(b=300 s/mm^(2))及FA(b=100、300、600 s/mm^(2))与AST、ALT、TNF-α水平及病理学积分存在较好的相关性(P<0.01)。结论FA与AST、ALT、TNF-α水平及病理学积分为兔肝IRI实验研究和临床治疗评估提供了一种可行性方法。Objective To observe changes of diffusion tensor imaging(DTI)parameters,average diffusion coefficient(DCavg)and fractional anisotropy(FA)in late stage of hepatic ischemia-reperfusion injury(IRI)in rabbits,and their correlations with aspartate aminotransferase(AST),alanine transaminase(ALT)and serum tumor necrosis factor-α(TNF-α)and histopathological scores under microscope.Methods Among 24 experimental rabbits,18 rabbits were used to establish IRI models,and were randomly divided into IRI 12 h group(n=6),IRI 24 h(n=6)and IRI 48 h(n=6),and other 6 rabbits were used as sham operation group.All groups were examined by magnetic resonance DTI(b=100,300,600 s/mm^(2))to detect levels of AST,ALT and TNF-α,and pathomorphological scores were evaluated.Correlations between serum levels of AST,ALT and TNF-αand pathomorphological score with DCavg and FA were analyzed by multivariate linear correlation.Results There were significant differences in levels of AST,ALT,TNF-αand pathomorphological score among the 4 groups(P<0.05).When b was equal to 100 s/mm^(2),DCavg level in IRI 24 h group was significantly lower than that in sham operation group(P<0.05).When b were equal to 100,300 and 600 s/mm^(2),DCavg levels in IRI 48 h group were significantly higher than those in IRI 24 h group(P<0.05).When b were equal to 300 and 600 s/mm^(2),FA levels in IRI 24 h group were significantly lower than those in sham operation group,and FA levels in IRI 48 h group were significantly lower than those in sham operation and IRI 12 h and 24 h groups(P<0.05).There were good correlations between DCavg(b=300 s/mm^(2))and FA(b=100,300,600 s/mm^(2))with levels of AST,ALT,TNF-αand pathological score(P<0.01).Conclusion FA,levels of AST,ALT and TNF-α,and pathological score provide a feasible method for the experimental study and evaluation for clinical treatment of rabbit's liver IRI.

关 键 词：肝缺血 再灌注损伤 弥散张量成像 平均扩散系数 各向异性系数 丙氨酸转氨酶 肿瘤坏死因子-α 兔 

分 类 号：R-332[医药卫生] R657.3