肝动脉栓塞术的磁共振灌注成像的评价

Evaluation of Transcatheter Arterial Embolization:Experiment Study of Magnetic Resonance Perfusion Imaging

【目的】探讨MR灌注成像定量检测肝动脉栓塞前后肝脏血流动力学的改变及应用价值。【方法】对8头健康实验家猪行肝动脉栓塞术,分别于栓塞前及栓塞后3d和1周行肝脏MR灌注扫描,计算肝脏各血流动力学参数,并行统计学分析。【结果】(1)实验家猪肝动脉栓塞前及栓塞后3d和1周的各项MR灌注测量肝脏血流参数中,HAP、PVP、THBF、PVI及DV的差异具有统计学意义(P=0.001,0.002,0.000,0.000和0.008),MTT的差异无统计学意义(P=0.17);(2)肝动脉栓塞后不同时间肝脏血流动力学参数变化特点:①术后3d实验家猪HAP较术前明显减低,PVI明显增加,差异有统计学意义(P=0.006,0.005),而PVP、THBF、MTT和DV较术前稍有增加,但差异均无统计学意义(P值分别为0.222、1.000、0.508和0.284);②术后1周实验家猪HAP、DV和MTT较术后3d有所增加,PVI较之减低,但差异无统计学意义(P=1.000、0.170、1.000和1.000),而PVP和THBF较术后3d明显增加,差异均有统计学意义(P值分别为0.008和0.005);③术后1周实验家猪PVP、THBF和DV较正常组明显增加,差异均有统计学意义(P值分别为0.031、0.013和0.038),而HAP、PVI及MTT较术前稍有增加,但差异无统计学意义(P值分别为0.196、0.177和0.078)。【结论】肝脏MR灌注成像能较准确地测定肝脏血流动力学参数,能在一定程度上反映肝动脉栓塞术后肝脏血流动力学的改变特点。

[Objective] To evaluate the practical utility of MR perfusion imaging in liver hemodynamics before and after transcatheter arterial embolization （TAE）. [Methods] TAE of the liver were performed on 8 pigs, and MR perfusion imaging of liver were performed before operation and 3 days, 1 week after operation, respectively. Liver perfusion parameters were calculated and analyzed statistically. [Results] （1） Among the hepatic blood flow parameters, there were statistically different for hepatic artery perfusion （HAP）, portal vein perfusion （PVP）, total hepatic blood flow （THBF）, portal vein perfusion index （PVI）, and distribution volume （DV） （P = 0.001, 0.002, 0.000, 0.000, and 0.008, respectively）, and there were no statistically difference for mean transit time （MTF） （P = 0.17）. （2） There were changes for the hepatic blood flow parameters in different time quantum pre- and post-TAE.①Compared to pre-operation, HAP decreased and PVI increased distinctly 3 days after operation, with statistical difference （P = 0.006, 0.005）. PVP, THBF, MTT, and DV increased, without statistical difference （P = 0.222, 1.000, 0.508, and 0.284）. ②Compared to 3 days after operation, HAP, DV, MTT increased and PVI decreased 1 week after operation, without statistical difference （P = 1.000, 0.170, 1.000, and 1.000）. PVP and THBF increased with statistical difference （P = 0.008, 0.005）. ③Compared to pre-operation, PVP, THBF, and DV increased distinctly 1 week after operation,with statistical difference （P = 0.031, 0.013, and 0.038）. PVP, PVI, and MTT increased without statistical difference （P = 0.196, 0.177, and 0.078）. [Conclusion] MR perfusion imaging can quantify the blood flow volume of liver accurately. It can reflect the hemodynamic changes after TAE at a certain extent.