MR三维全肝灌注成像在结直肠癌肝转移定量分析中的可行性研究

Quantitative Study of Three-Dimensional Whole-Liver Perfusion MR Imaging in Patients with Colorectal Hepatic Metastases

目的:探讨MR三维全肝灌注成像对结直肠癌肝转移定量分析的可行性。方法:对27例结直肠癌肝转移患者行MR三维全肝灌注成像扫描,采用三维容积屏气内插检查序列,对比剂按0.1 mmol/kg体质量计算,注射速度5 mL/s。由2名放射科医师采用Tissue 4D软件分析灌注参数:容量转移常数(Ktrans)、血管外细胞外间隙容积比(Ve)、速率常数(Kep)。采用计算一致性相关系数和Bland-Altman分析2位医师各参数结果间的一致性。结果:2位医师评价27例结直肠癌肝转移灌注参数的Ktrans、Ve和Kep的观察者间一致性经Bland-Altman分析,其平均差异分别为(0.0069±0.0135)min-1、(-0.0084±0.0371)min、(0.0385±0.0685)min-1;95%一致性界限分别为-0.0196～0.0333、-0.0812～0.0644、-0.0958～0.1728。而Ktrans、Ve和Kep的一致性相关系数分别为0.95、0.94和0.99。结论:采用MR三维全肝灌注成像技术进行结直肠癌肝转移定量分析具有良好的可靠性和可行性。

Objective：To assess the feasibility of three-dimensional（3D） whole-liver perfusion MR imaging for the quantitative analysis of colorectal hepatic metastases（CRHMs）. Methods： 3D whole-liver perfusion MR imaging was performed in 27 pa- tients with CRHMs using 3D volume-interpolated breath-hold examination（VIBE） sequence,which were obtained during the in- jection of 0.1 mmol/kg （body weight） of contrast medium at 5 mL/s. The following estimated perfusion parameters were measured with semi-automatic software（Tissue 4D） by two radiologists：the volume transfer constant （Ktrans）, the volume of extravascular extracellular space（EES） per volume unit of tissue（Ve）, and the flux rate constant between EES and plasma（Kep）. Statistical analysis was done using concordance correlation coefficient（CCC） measurements and Bland-Altman plots. Results.. The mean differences for inter-observer agreement analysis for the 27 patients with CRHMs were （0. 0069 ± 0. 0135） mini for Ktrans, （-0. 0084 ± 0. 0371 ） for Ve, （0. 0385 ± 0. 0685） min-1 for Kep, respectively; and 95 % limits of agreement were -0. 0196 to 0. 0333 for Ktrans,-0. 0812 to 0. 0644 for Ve,-0. 0958 to 0. 1728 for Kep, respectively. The values of CCC measurements for Ktrans, Ve and Kep were 0.95,0.94 and 0.99, respectively. Conclusions： 3D whole-liver perfusion MR imaging with semi-automatic data analysis is feasible for the quantitative evaluation of the perfusion parameters for CRHMs.