单指数、双指数、拉伸指数弥散加权成像及三维动脉自旋标记成像在肝性脑病的应用  

The value of diffusion-weighted imaging of mono-,bi-and stretched exponential models and three dimensional arterial spin labeling imaging in hepatic encephalopathy

作　　者：张媛媛[1] 宋育林[2] 汪楠 Zhang Yuanyuan;Song Yulin;Wang Nan(Department of Medicine,Anqing Medical and Pharmaceutical College,Anqing 246052,Anhui,China;Department of Gastronenterology,The First Affiliated Hospital of Anhui Medical University,Hefei 230022,China;Department of Radiology,Anqing Municipal Hospital,Anqing 246003,Anhui,China;Radiology DepartmentⅡof Hotan District People's Hospital,Hotan 848000,Xinjiang,China)

机构地区：[1]安庆医药高等专科学校医学院,安徽安庆246052 [2]安徽医科大学第一附属医院消化内科,安徽合肥230022 [3]安庆市立医院医学影像科,安徽安庆246003 [4]和田地区人民医院放射二科,新疆和田848000

出　　处：《兰州大学学报（医学版）》2023年第8期60-67,共8页Journal of Lanzhou University（Medical Sciences）

基　　金：安徽省自然科学研究重点项目(KJ2019A1238)。

摘　　要：目的探讨多模型弥散加权成像和三维动脉自旋标记成像在肝性脑病的应用价值。方法回顾性分析60例肝性脑病患者和60例同期体检中心健康受试者的弥散加权成像和三维动脉自旋标记成像脑功能磁共振图像,利用GE AW 4.6 Function tool后处理软件测量23个感兴趣区单指数模型的表观扩散系数值、双阶单指数模型的弥散系数值、假性弥散系数值、灌注分数值、拉伸指数模型的分布扩散系数值、扩散异质性指数值以及三维动脉自旋标记成像脑血流量,并分析肝性脑病组与对照组间各参数值的差异。结果选取的23个感兴趣区中,有18个区域的分布扩散系数参数降低差异有统计学意义(P<0.05)。在体素内不相干运动成像多模型参数(除外灌注分数值)差异有统计学意义(P<0.05)的10个感兴趣区(双侧顶叶、枕叶、颞叶、额叶及后扣带回)中,只有双侧后扣带回的脑血流量升高。结论弥散加权成像不同模型为肝性脑病增加了影像学信息。双侧后扣带回灌注和代谢的变化与肝性脑病患者肝功能分级有关。Objective To investigate the clinical significance of diffusion weighted imaging and three dimensional arterial spin labeling in the diagnosis of hepatic encephalopathy with mono-,bi-and stretched exponential models.Methods Diffusion weighted imaging and three dimensional arterial spin labeling magnetic resonance images of the brain from 60 hepatic encephalopathy patients and 60 healthy subjects in the same period from a medical checkup center were retrospectively analyzed.The apparent diffusion coefficient of the single exponential model,true diffusion coefficient of the double-order single exponential model,pseudo-diffusion coefficient,perfusion fraction,distributed diffusion coefficient of stretched exponential model,heterogeneity of intravoxel diffusion and three dimensional arterial spin labeling cerebral blood flow in the 23 regions of interests were measured using the GE AW 4.6 Function tool post-processing software.Besides,the differences in these parameters between the hepatic encephalopathy group and the control group were analyzed.Results Of the 23 regions of interests in this study,the reductions in the distributed diffusion coefficient in 18 regions of interests were statistically significant(P<0.05).Of the regions of interest(bilateral parietal,occipital,temporal,frontal,and posterior cingulate cortex)in which the difference in the intravoxel incoherent motion imaging multimodel parameter(except for the perfusion fraction)was statistically significant(P<0.05),and cerebral blood flow increased only in the bilateral posterior cingulate cortex.Conclusion Diffusionweighted imaging of different models provided more imaging information for the diagnosis of hepatic encephalopathy.Changes in perfusion and metabolism in the bilateral posterior cingulate cortex were related to liver function grading in hepatic encephalopathy patients.

关 键 词：肝性脑病 弥散加权成像 动脉自旋标记 磁共振成像 

分 类 号：R445.2[医药卫生—影像医学与核医学]