肝纤维化、肝硬化的MRI评价指标与病理学分期的相关性研究

Collelation of MRI Evaluated Indexes with Histopathological Stages of Liver Fibrosis and Hepatic Cirrhosis

目的探讨肝纤维化、肝硬化的各叶径线改变及肝内外血管变化与不同病理分期间的相关性。方法采用MRI扫描仪对经病理学证实的肝纤维化S1期9例,S2期11例,S3期10例,S4期12例,正常对照组15名进行肝脏的平扫及肝脏加速容积采集(LAVA)动态扫描,参照李天然的测量方法,分别测量肝左叶冠状径(L1)、肝左叶矢状径(L2)、肝右叶冠状径(R1)、肝右叶矢状径(R2)、肝尾状叶冠状径(C1)值以及测量门静脉主干及其左右分支、脾静脉、肝中静脉的宽度,并计算R1/L1、R1/C1值。结果从S1期到S4期的L1值逐渐增大,仅S4期的L1值与各组间有统计学意义。R1、R2值从S1期到S2期轻度增大,但随着肝纤维化的进程又轻度减小,但各组间比较无统计学意义;为了消除体格因素的差异,进行了R1/L1、R1/C1的计算,其中S4期的R1/L1值与各组间有统计学意义。各期诸血管的比较中,S4期的肝中静脉管径与各组间比较有统计学意义。结论肝脏各径线及肝内外血管的变化与肝纤维化、肝硬化程度密切相关。

Objective To analyze the correlation between the changes of liver lobic lengths, blood vascular diameters and the different histopathological stages of liver fibrosis and hepatic cirrhosis. Methods MRI scan was performed in 57 panticipants, including 42 patients with liver fibrosis with included S1 （9/42）, S2 （ 11/42）, S3 （ 10/42）, S4 （ 12/42 ） com-finned by liver pathologic biopsy, and 15 control subjects. Refer to LI Tian Ran＇method, The lengths of L1, L2, R1, R2, C1 and the diameters of portal vein, left portal vein, right portal vein, splenic vein, middle hepatic vein were measured re- spectively, R1/L1 and R1/C1 were calculated. Results From S1 to S4, L1 of the left lateral lobe enlarged gradually, and L1 of S4 stage had significant difference with other groups. R1, R2 of the right lobe in S1, S2 stage enlarged slightly but re- duced slightly at S3 ,S4 stage and no statistical difference existed between groups. R1/L1, R1/C1 was calculated in order to get rid of physiologic difference, and R1/L1 between S4 and other groups was statistical difference. MHV in S4 stage had statistical difference with others groups. Conclusion The length changes of hepatic lobe and the diameter changes of blood vessels are closely correlated with the severity of liver fibrosis and hepatic cirrhosis.