积极开展定量动态增强磁共振成像研究

An expectable wave of clinical studies using quantitative dynamic contrast-enhanced MR imaging

基于快速T1加权成像动态增强磁共振成像(dynamic contrast-enhanced MRI,DCE-MRI)是一种无创地评价组织和病变微循环特性的一种功能性成像方法,可对组织的血流灌注及微血管渗透性的血流动力学状态进行定性、半定量和定量分析。定量DCE-MRI因计算时纳入动脉输入函数及组织中对比剂浓度因素,较定性及半定量指标反映血流灌注及微血管渗透性更为准确,且可避免定性及半定量分析结果受扫描技术影响而出现的研究者间的差异,不仅有利于提高对肿瘤的早期诊断及鉴别诊断的准确性,还可有助于开展临床多中心随机对照研究,获得关于疾病诊断及治疗方面的循证医学数据。目前DCE-MRI尚存在扫描技术是否规范,数据分析是否运动矫正、是否根据感兴趣组织器官或疾病特点,恰当选用相应的血流动力学模型的问题。采用先进的定量DCE-MRI的专用分析软件能为数据分析提供规范化平台,进一步推动和拓展定量DCE-MRI的临床研究。

Quantitative dynamic contrast-enhanced MR imaging （dynamic contrast-enhanced MRI, DCE-MRI） using fast T1-weighted imaging is considered as a functional tool to non-invasively assess the microcirculation features of normal or diseased tissues. It can be used to assess tissue perfusion and microvessel permeability by means of qualitative, semi-quantitative and quantitative method. With inclusion of arterial input function and tissue concentration of contrast agents used, quantitative DCE-MRI is superior to either qualitative or semi-quantitative method with respect to accurate evaluation of tissue perfusion and microvessel permeability; and can avoid inconsistent analysis results between different researchers caused by individual scanning protocols used. Thus quantitative DCE-MRI is not only favorable to achieve an early diagnosis and improve accuracy of the differential diagnosis of various disease entities, but also helpful for implementation of a multicenter randomized control clinical trials to obtain evidence medicine data. To date, some obstacles are still present in DCE-MRI, such as the standardization of scanning protocols and data computation, particularly the application of appropriate hemodynamic models. Advanced software specialized designed for quantitative DCE-MRI can provide a standard and convenient platform for data analysis. With the help of such favorable platform, the progress of clinical application of DCE-MRI would be promoted and its application ifeld would be extended.