超声双模态影像技术联合动态增强磁共振检查对大鼠早期肝纤维化的评估价值实验研究  

Evaluation value of ultrasound dual-modality imaging technique combined with DCE-MRI in rats with early hepatic fibrosis

作　　者：姜帆 李春香 李忠原 JIANG Fan;LI Chunxiang;LI Zhongyuan(Postgraduate Training Base,First Affiliated Hospital of Qiqihar Medical University of Jinzhou Medical University,Qiqihar 161041,China)

机构地区：[1]锦州医科大学齐齐哈尔医学院附属第一医院研究生培养基地,黑龙江齐齐哈尔161041 [2]齐齐哈尔市传染病防治院,黑龙江齐齐哈尔161041

出　　处：《陕西医学杂志》2023年第3期273-277,共5页Shaanxi Medical Journal

基　　金：黑龙江省卫生健康委员会科研课题(20210909040360);黑龙江省齐齐哈尔市科技计划联合引导项目(LSFGG-2022066)。

摘　　要：目的:探讨超声双模态影像技术联合动态增强磁共振(DCE-MRI)检查对大鼠早期肝纤维化(HF)的评估价值。方法:将SD大鼠48只随机分为对照组、M4组、M6组和M8组,每组12只。对照组自由饮食及摄水。模型组(M4、M6、M8组)采用CCl 4加乙醇复合法对大鼠进行诱导,M4、M6、M8组分别注射4、6、8周。采用常规超声、超声弹性成像、常规MRI及DCE-MRI对大鼠肝脏进行检查。处死大鼠后,取血清检测谷丙转氨酶(ALT)、谷草转氨酶(AST)、透明质酸(HA)、层粘连蛋白(LN)、Ⅲ型前胶原N端肽(PCⅢNP)、Ⅳ型胶原(CⅣ)含量;取肝组织固定后行HE染色,光镜下观察病理变化。结果:常规超声检查结果显示,对照组大鼠肝脏无异常变化,而模型组大鼠肝脏的形态发生改变。超声弹性成像结果显示,与对照组比较,模型组大鼠肝脏弹性值随着纤维化程度的加重而呈上升趋势(均P<0.05)。常规MRI检查结果显示,对照组大鼠肝脏形态正常,M4、M6、M8组大鼠肝脏出现形态改变,M8组大鼠肝脏变化最为明显。DCE-MRI检查结果显示,随着大鼠HF分级的不断进展,K^(trans)、K_(ep)、V_(e)、iAUC呈依次下降趋势(均P<0.05)。血清学检测结果显示,随着大鼠HF分级的不断进展,ALT、AST、HA、LN、PCⅢNP、CⅣ呈依次升高趋势(均P<0.05)。HE染色结果显示,对照组大鼠肝组织正常,模型组大鼠肝组织出现不同程度的纤维增生。结论:在评估早期肝纤维化的无创诊断技术中,超声双模态影像技术联合动态增强磁共振可有效地提高评估肝纤维化严重程度的能力。Objective:To investigate the evaluation value of ultrasound dual-modality imaging technique combined with dynamic contrast-enhanced magnetic resonance imaging(DCE-MRI)in rats with early hepatic fibrosis(HF).Methods:Forty-eight SD rats were randomly divided into control group,M4 group,M6 group and M8 group,with 12 rats in each group.The control group was allowed free diet and water.The model group(M4,M6,and M8 groups)was induced with CCl 4 and ethanol foR4,6,and 8 weeks,respectively.The livers of rats were examined by conventional ultrasound,ultrasound elastic imaging,conventional MRI,and DCE-MRI.After the rats were executed,serum was taken to determine the levels of ALT,AST,HA,PCⅢNP and CⅣ;liver tissues were fixed and stained with HE,and pathological changes were observed by light microscopy.Results:Conventional ultrasound examination revealed that no abnormal changes in control group,whereas morphological changes were observed in model group.Ultrasound elastic imaging showed that the ultrasound elasticity values increased as the degree of liver fibrosis increased in model group in comparison with control group(all P<0.05).Conventional MRI showed normal morphology in control group,but M4,M6 and M8 groups showed morphological changes that were most pronounced in M8 group.DCE-MRI examination shouwed that K^(trans),K_(ep),V_(e)and iAUC decreased as the increase of HF grade(all P<0.05).Serologic tests showed an increasing trend in ALT,AST,HA,LN,PCⅢNP,and CⅣas the increase of HF grade(all P<0.05).HE staining showed normal liver tissue in control group and varying degrees of fibrosis in model group.Conclusion:Among the noninvasive diagnostic techniques for the assessment of early liver fibrosis,ultrasound dual-modality imaging technique combined with DCE-MRI effectively can improve the ability to assess the severity of liver fibrosis.

关 键 词：肝纤维化 超声弹性成像 动态增强磁共振 血清学指标 HE染色 大鼠 

分 类 号：R575.2[医药卫生—消化系统]