基于四维血流磁共振成像的肝硬化门静脉血流动力学研究  

Study of Portal Vein Hemodynamics in Liver Cirrhosis Based on Four-Dimensional flow Magnetic Resonance Imaging

作　　者：马帅 赵卫[1] 刘敏[1] 刘芳志 杨美英 王滔[1] MA Shuai;ZHAO Wei;LIU Min(Department of Medical Imaging,the First Affiliated Hospital of Kunming Medical University,Kunming,Yunnan Province 650032,P.R.China)

机构地区：[1]昆明医科大学第一附属医院医学影像科,650032

出　　处：《临床放射学杂志》2025年第3期465-471,共7页Journal of Clinical Radiology

基　　金：云南省重大科技专项基金资助项目(编号:202102AA100067)。

摘　　要：目的使用四维血流磁共振可视化定性及定量分析肝硬化门静脉系统血流动力学并对其进行表征。方法应用四维血流磁共振成像定性、定量分析肝硬化及志愿者门静脉系统血流动力学;统计学方法采用t检验、Kappa检验及Spearmen相关性分析。结果肝硬化患者和志愿者的总体可视化成功率分别为94.2%和98%。定量分析显示与志愿者相比,肝硬化患者肠系膜上静脉(SMV)、门静脉左支(LPV)容量明显增大(P<0.01),门静脉分叉处(PVB)及门静脉右支(RPV)血流容量相对减小(P<0.01)。除LPV外,门静脉及其分支、属支肝硬化患者的血流峰值速度和平均速度均小于志愿者(P<0.05),肝硬化患者最大压力梯度比志愿者更小(P<0.05)。脾静脉(SV)、SMV、LPV血流量随疾病的发生而增加,脾-肠系膜上静脉汇合处(SMC)、PVB、RPV则相对减少。结论四维血流磁共振成像对肝硬化患者门静脉系统血流动力学的深入评估是可行的,为脏器系统改变的病理生理提供了额外信息。Objective To qualitatively and quantitatively analyze the hemodynamics of the portal vein system in liver cirrhosis using four-dimensional flow magnetic resonance imaging(4D Flow MRI).Methods The hemodynamics of the portal vein system in patients with liver cirrhosis and healthy volunteers were analyzed qualitatively and quantitatively using 4D Flow MRI.Statistical methods included t-tests,Kappa tests,and Spearman correlation analysis.Results The overall visualization success rates were 94.2%in patients with cirrhosis and 98%in volunteers.Quantitative analysis showed that,compared with volunteers,patients with cirrhosis had significantly increased volumes of the superior mesenteric vein(SMV)and left portal vein(LPV)(P<0.01)and decreased flow volumes in the portal vein trunk and right portal vein(P<0.01).Except for the left portal vein branch,peak and mean blood flow velocities in the portal vein and its branches were lower in patients with cirrhosis than in volunteers(P<0.05),and the maximum pressure gradient was smaller in patients with cirrhosis than in volunteers(P<0.05).Blood flow in the SMV,splenic vein(SV),and LPV increased with disease progression,while that in the splenic mesenteric collateral(SMC),portal vein branches(PVB),and right portal vein(RPV)decreased.Conclusion 4D Flow MRI is feasible for the in-depth assessment of portal vein system hemodynamics in patients with cirrhosis and provides additional information for the pathophysiology of organ system changes.

关 键 词：四维血流磁共振成像 肝硬化 门静脉 血流动力学 

分 类 号：R575.2[医药卫生—消化系统] R445.2[医药卫生—内科学]