四维血流磁共振成像在肝硬化患者门静脉系统解剖和血流动力学的可行性研究  

Feasibility Study of 4D Flow MRI on Portal Vein System Anatomy and Hemodynamics in Patients with Cirrhosis

作　　者：马帅 赵卫[1] 胡继红[1] 易根发[1] 董成洲 王滔[1] MA Shuai;ZHAO Wei;HU Jihong(Department of Radiology,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4期651-657,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 探讨四维血流磁共振成像(4D Flow MRI)定性、定量分析肝硬化患者门静脉系统解剖和血流动力学的可行性及有效性。方法 前瞻性搜集20例经病理穿刺证实为肝硬化的患者,患者均行4D Flow MRI、多普勒超声和数字减影血管造影(DSA)检查,可视化、量化门静脉系统解剖和功能参数,分析4D Flow MRI的可重复性,及其与多普勒超声、DSA的相关性。结果 4D Flow MRI对门静脉系统显示良好,未出现渗漏,总体可视化高达95%;在血流动力学方面,除脾静脉有效流量外,4D Flow MRI和多普勒超声之间存在低至高度相关性(r=0.35~0.86);4D Flow MRI在门静脉系统大多平面的面积、最大和最小直径的定量分析中与DSA同样具有一定相关性(r=0.32~0.68)。在MR成像中,除肠系膜上静脉(SMV)、脾-肠系膜上静脉汇合处(SMC)有效流量和脾静脉(SV)、门静脉分叉处(PVB)平均速度以及SV最大速度被高估外,其余均被低估(P<0.050);与4D Flow MRI相比DSA显示的血管面积和最大、最小直径更小,除左肝内门静脉分支(LPV)、右肝内门静脉分支(RPV)和曲张静脉面积以及PVB、RPV、曲张静脉最小直径外均具有统计学差异(P<0.050)。结论 4D Flow MRI对肝硬化患者门静脉系统解剖和血流动力学的定性、定量评估是可行的,同时可为肝脏疾病提供更多额外的信息。Objective To explore the feasibility and effectiveness of qualitative and quantitative analysis of portal vein system anatomy and hemodynamics in patients with cirrhosis using four-dimensional flow magnetic resonance imaging.Methods Twenty patients with cirrhosis confirmed by pathological biopsy were prospectively collected.All patients underwent 4D Flow MRI,ultrasound and digital subtraction angiography to visualize and quantify the anatomical and functional parameters of the portal vein system,and analyze the repeatability of 4D Flow MRI and its correlation with ultrasound and DSA.Results The portal vein system showed good results with no leakage and the overall visualization rate reached 95%.In terms of hemodynamics,there was a low to high correlation between 4D Flow MRI and Doppler ultrasound(r=0.35-0.86) except for the splenic vein effective flow.4D flow MRI also showed a certain correlation with digital subtraction angiography(0.32-0.68) in the quantitative analysis of the area,maximum and minimum diameter of most planes of the portal vein system.In MR imaging,except for the mean and maximum velocity of the left portal vein and the maximum velocity of the right portal vein,blood flow and blood flow velocity were significantly underestimated(P<0.050),except for the vascular area,which was smaller and the maximum and minimum diameters showed by digital subtraction angiography.Except for the area and minimum diameter of the left and right branches of portal vein and varicose vein,there were statistical differences(P<0.050).Conclusion 4D Flow MRI is feasible for qualitative and quantitative evaluation of portal vein system anatomy and hemodynamics in patients with cirrhosis,and can provide additional information for hepatic pathology.

关 键 词：四维血流磁共振成像 肝硬化 门静脉系统 血流动力学 解剖参数 

分 类 号：R73[医药卫生—肿瘤]