钆塞酸二钠DCE-MRI定量评估慢性肝炎的初步研究

A Preliminary Study for the Quantitative Assessment of Chronic Hepatitis by Dynamic Contrast-Enhanced Magnetic Resonance Imaging

目的探讨钆塞酸二钠(Gd-EOB-DTPA)动态增强(DCE) MRI在慢性肝炎分级分期中的价值。方法利用Gd-EOB-DTPA DCE-MRI分析慢性肝炎大鼠的最大上升斜率(WIR)、达峰时间(TTP)、最大相对强化程度(MRE)及肝胆期相对强化值(RE)与肝脏病理的关系。结果肝TTP和肝纤维化程度(S)呈正相关(P=0. 011);肝WIR、MRE均与炎症活动度(G)呈正相关(P <0. 05);RE和S、G均相关(P <0. 05)。TTP在S各组间差异具有统计学意义(F=9. 179,P=0. 000),WIR、MRE在G各组间差异具有统计学意义(P <0. 05)。结论肝脏TTP随S的增加而延长,WIR、MRE均随G的增加而增大,肝胆期RE值不能独立地评估肝S。

Objective To assess the value of dynamic contrast-enhanced magnetic resonance imaging(DCE-MRI)with Disodium gadoxate(Gd-EOB-DTPA)for the grading and staging of chronic hepatitis.Methods Measured MR parameters,which included wash in rate(WIR),time to peak(TTP),maximum relative enhancement(MRE)and relative enhancement degree(RE)of hepatobiliary phase for Gd-EOB-DTPA DCE-MRI,and analyzed their relationship with the pathological manifestations of the rats with chronic hepatitis.Results There was positive correlation between hepatic TTP value and fibrotic stage(P=0.011),and no correlation with inflammatory grade(P=0.116)or steatosis(P=0.055).There were positive correlations between hepatic WIR value(P=0.028)or MRE value(P=0.016)and inflammatory grade,and no correlation with other factors(P>0.05).There were correlations between hepatic RE value and fibrotic stage(r=-0.515,P=0.010),or inflammatory activity(r=0.726,P=0.000).There was no correlation between RE value and steatosis(P=0.669).There were significant differences for the TTP values among the groups with fibrosis(F=9.179,P=0.000),and for the WIR and MRE values among the groups with inflammatory activity(P<0.05).Conclusion The hepatic TTP values was positively related to fibrosis,the hepatic WIR and MRE values were all positively related to inflammatory activity.The hepatic RE values were negatively related to fibrosis,but positively related to inflammatory activity.