基于Exchange血流动力学模型的MRI扫描参数诊断肝硬化临床价值分析

Clinical value of MRI scanning based on exchange hemodynamics model in evaluating liver cirrhosis

目的探讨MRI增强扫描Exchange血流动力学模型评估肝硬化患者病情的临床应用价值及其意义。方法在60例慢性乙型肝炎和慢性丙型肝炎患者及30例健康体检者,均接受肝活检和肝脏DCE-MRI检查,通过检测双输入双室Exchange血流动力学模型得到参数指标,包括对比剂容积转运常数(Ktrans)、速度常数(Kep)、血管外细胞外间隙容积分数(Ve)、血浆容积分数(Vp)、肝动脉灌注指数(HPI)以及对比剂平均通过时间(MTT)、达峰时间(TTP)、血容量(BV)、血流量(BF)。结果在60例患者中,经肝组织病理学检查,诊断为S1期3例,S2期3例,S3期1例和S4期53例;肝纤维化患者Ktrans和Ve指标较对照组显著降低(P<0.05),而HPI、MTT、TTP水平较对照组显著升高(P<0.05);ROC曲线分析显示Ktrans、HPI、MTT和TTP诊断肝硬化的效能较高(P<0.05)。结论基于双输入双室Exchange血流动力学模型的DCE-MRI检查可得到多个定量参数,在诊断肝硬化方面具有良好的指导意义。

Objective To investigate the clinical value of MRI enhanced exchange hemodynamic model in evaluating liver cirrhosis.Methods Results Out of 60 patients with chronic hepatitis B and chronic hepatitis C,the histopathological examination showed that fibrosis S1 in 3,S2 in 3,S3 in 1 and S4 in 53;the Ktrans and Ve in patients with advanced fibrosis decreased,while HPI,MTT and TTP increased significantly as compared to those without(P<0.05);ROC analysis showed that Ktrans,HPI,MTT and TTP had a high efficacy in diagnosing liver cirrhosis(P<0.05).Conclusion Several quantitative parameters can be obtained in DCE-MRI based on double-input and double chamber exchange hemodynamics model,which might be good parameters in guiding the diagnosis of patients with liver cirrhosis.