动态增强MRI定量分析股骨头缺血性坏死介入治疗后的血流变化

Effect of interventional therapy on quantitative analysis of dynamic enhanced MRI for avascular necrosis of femoral head

目的:探讨股骨头缺血性坏死(ANFH)动态增强MR参数改变与介入疗效的相关性。方法:30例ANFH介入治疗前、治疗后近期均行动态增强MRI扫描,绘制时间-信号强度曲线,测量和计算峰值、最大强化值、最大强化比值、最大斜率等各种参数,然后按常规方法进行疗效评估,并进行比较,观察ANFH介入治疗前后动态增强MR参数的变化与介入疗效的关系。结果:ANFH介入治疗前后时间-信号强度曲线的峰值分别为19.504±1.231,42.125±1.351(P<0.05);最大强化值分别为8.962±0.153,18.177±2.324(P=0.05);最大强化比值分别为1.851±0.231,1.76±0.034(P>0.05);最大斜率分别为0.251±0.011,0.412±0.023(P>0.05)。ANFH介入治疗前后峰值的变化与介入疗效相关(r=0.475,P<0.01)。结论:动态增强MR部分参数与疗效有密切关系,可用来评估介入疗效,作为临床的辅助参考。

Objective： To study the correlation between interventional therapy effect and the changes of some parameters of dynamic en- hanced MRI. Methods： Dynamic enhanced MRI was performed shortly before and after interventional therapy in 30 patients with avascular necrosis of femoral head. Time intensity curve（TIC） were charted. Some parameters, such as peak intensity, maximum enhancement value, maximum enhancement ratio, the steepest slope etc. were measured and calculated. The interventional therapy effect was evaluated by the traditional methods. The correlation between interventional therapy effect and the changes of some parameters of dynamic MRI was analyzed. Results： Peak intensity of TIC before and after interventional therapy was 19. 504 ± 1.231 and 42. 125 ± 1.351 （ P 〈 0.05 ）, maximum enhancement values 8. 962 ± 0. 153, 18. 177 ± 2. 324 （ P = 0.05 ） ; maximum enhancement ratio 1.85 ± 0.231, 1.76 ± 0.034 （ P 〉 0.05 ） and the steepest slopes 0.251 ± 0.011,0. 412 ± 0. 023 （ P 〉 0.05）. Conclusion： The changes of some parameters of dynamic MRI after interventional therapy in ANFH patients are well correlated with interventional therapy effect, therefore, dynamic enhanced MRI may be useful in estimation of interventional therapy effect, which provides a supplementary reference.