增强MRI对自身免疫性肝病肝小叶结构的研究  

The Study of the Hepatic Lobular Structure Hepatocyte of Autoimmune Liver Diseases Using Enhanced MRI

作　　者：黄梦月 陈雅乐 黄梦娜[1] 高雪梅[1] 张勇[1] 程敬亮[1] 李彩霞 刘静静[1] HUANG Meng-yue;CHEN Ya-le;HUANG Meng-na;GAO Xue-mei;ZHANG Yong;CHENG Jing-liang;LI Cai-xia;LIU Jing-jing(Department of Magnetic Resonance,the First Affiliated Hospital of Zhengzhou University,Zhengzhou 450052,Henan Province,China;Department of Magnetic Resonance,Zhengzhou Seventh People's Hospital,Zhengzhou 450016,Henan Province,China;Department of Magnetic Resonance,the First Affiliated Hospital of Henan Polytechnic University,Jiaozuo 454003,Henan Province,China)

机构地区：[1]郑州大学第一附属医院磁共振科,河南郑州450052 [2]郑州市第七人民医院核磁共振室,河南郑州450016 [3]河南理工大学第一附属医院磁共振室,河南焦作454003

出　　处：《中国CT和MRI杂志》2024年第11期95-97,共3页Chinese Journal of CT and MRI

基　　金：2021年度河南省医学科技攻关计划项目(SBGJ202102111);2016年郑州大学第一附属医院院内青年创新基金项目(YNQN2017158);2017年河南理工大学基本科研业务费专项项目(NSFRF170710)。

摘　　要：目的探讨肝细胞特异性对比剂磁共振成像T1 mapping对自身免疫性肝病肝小叶结构破坏的评估价值。方法搜集我院病理证实的自身免疫性肝病患者66例,分别于注射肝细胞特异性对比剂前、及后5分钟行T1 mapping扫描。根据病理结果分为肝小叶结构破坏组(47例)和肝小叶结构完整组(19例)。于近第一肝门水平测量增强前后肝实质T1弛豫时间(分别为T1pre和T1post),并计算ΔT1=(T1pre-T1post)/T1pre。采用独立样本t检验分析参数的组间差异,并绘制受试者工作特征曲线。结果在肝小叶结构完整组与破坏组间T1pre、T1post和T1差异有统计学意义(所有P<0.05)。T1pre、T1post、T1诊断肝小叶结构破坏的曲线下面积分别为0.828、0.826、0.740,临界值分别为894.37 ms、351.99 ms、60.53%,敏感度分别为75.0%、100.00%、93.75%,特异度分别为90.00%、49.00%、46.00%。T1pre、T1post、ΔT1联合诊断的AUC均大于其单一参数。结论T1pre、T1post、ΔT1可预测肝小叶结构的完整性,其联合诊断价值大于单一参数。Objective To evaluate the damage of hepatic lobule structure in autoimmune liver disease by T1 mapping on Gd-EOB-DTPA-enhanced MRI.Methods Sixty-six patients with autoimmune liver disease confirmed by pathology in our hospital underwent conventional upper abdominal T1 mapping before and after injecting Gd EOB DTPA 5 minutes.According to the pathological destruction of the hepatic lobular structure,the patients were divided into the destruction group(47 cases)and the complete group(19 cases).T1 relaxation time(T1pre,T1post)of the liver before and after enhancement(5min)were measured in the liver parenchyma near the first hepatic portal,and calculatedΔT1=((T1pre-T1post)/T1pre).The independent sample t-test was used to analyze the differences of T1pre,T1post,andΔT1 between the destruction group and the complete group.Statistically significant parameters were used to draw the subject's working characteristic curve.Results There were significant differences in T1pre,T1post,andΔT between the destruction group and the complete group(all P<0.05).The area under the curve(AUC)of T1pre,T1post,andΔT1 diagnosing hepatic lobular structural damage was 0.828,0.826,0.740,and the critical values were 894.37 ms,351.99 ms,60.53%,the sensitivity was 75.00%,100.00%,93.75%,and the specificity was 90.00%,49.00%,46.00%.The AUC of combined diagnosis in T1pre,T1post,andΔT1 is greater than its single parameter.Conclusion T1pre,T1post,ΔT1 can predict the destruction of the hepatic lobular structure,and its combined diagnostic value is greater than a single parameter.

关 键 词：T1 mapping 自身免疫性肝病 肝小叶结构 肝细胞特异性对比剂 

分 类 号：R445.2[医药卫生—影像医学与核医学] R575[医药卫生—诊断学]