定量MRI评价肝泡型包虫病肝储备功能的初步探讨
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摘要
目的:探讨磁共振T_1-mapping、T_2-mapping定量评价肝泡型包虫病(HAE)肝功能的临床应用价值。方法:搜集本院行肝脏磁共振T_1-mapping及T_2-mapping扫描的36例HAE患者(病例组)和20例肝脏功能正常的健康志愿者(对照组)。根据Child-Pugh分级评分将病例组分为肝功能A级组(n=14)、B级组(n=12)和C级组(n=10)。分别测量肝泡型包虫病例组及对照组正常肝实质的弛豫时间,得到T_1值和T_2值,采用方差分析两两比较四组间T_1、T_2值。结果:对照组T_1值为(338.9±95.6)ms,T_2值为(42.7±3.1)ms;病例A组T_1值为(393.47±158)ms,T_2值为(43.74±5.3)ms;B组T_1值为(351.5±84.7)ms,T_2值为(57.85±7.7)ms;C组T_1值为(460.9±76.0)ms,T_2值为(65.9±3.0)ms。各组间T_1值差异均无统计学意义(P>0.05),对照组T_2值与病例A组差异无统计学意义(P>0.05),对照组与病例B组、C组及病例组A、B、C各组间差异有统计学意义(P<0.05)。结论:肝泡型包虫病例随肝功能C-P分级不同,其T_2值存在差异,磁共振T_2-mapping成像有望用于定量评价肝脏储备功能,为临床医师评估肝泡型包虫肝脏储备功能提供一种新的手段。T_1值定量评价HAE肝功能仍需论证。
Objective:The purpose of this study was to assess the clinical application value of T_1-mapping and T_2-mapping MR scan for assessment of liver function in patients with hepatic alveolar echinococcosis(HAE).Methods:36 patients with HAE(male 17,female 19) and 20 volunteers(male 10,female 10) underwent both T_1 and T_2-mapping scan.20 cases of control group and HAE groups were divided into three groups according to Child-Pugh score:group A(n=14),group B(n=12),group C(n=10).T_1 and T_2 values were measured by Siemens workstation in residual liver parenchyma of HAE group and in liver parenchyma of control group. The variance analysis was used to compare the T_1 and T_2 values between the four groups.Results:The measurements of T_1 and T_2 average values were as below:control group [T_1(338.9±95.6)ms,T_2(42.7±3.1)ms];group A [T_1(393.47±158)ms,T_2(43.74±5.3)ms];group B [T_1(351.5±84.7)ms,T_2(57.85±7.7)ms];group C [T_1(460.9±76.0)ms,T_2(65.9±3.0)ms].There was no statistically significant difference found in T_1 values between the 4 groups(P>0.05).However,T_2 values were statistically significant differences between the control group and group B and C(P<0.05),and between group A and B and C(P<0.05),however,but no significant difference in T_2 velues between healthy group and group A(P>0.05).Conclusion:T_2-mapping sequence may be useful for the assessment of liver function of HAE,while T_1-mapping sequence still need to investigate.
Objective:The purpose of this study was to assess the clinical application value of T_1-mapping and T_2-mapping MR scan for assessment of liver function in patients with hepatic alveolar echinococcosis(HAE).Methods:36 patients with HAE(male 17,female 19) and 20 volunteers(male 10,female 10) underwent both T_1 and T_2-mapping scan.20 cases of control group and HAE groups were divided into three groups according to Child-Pugh score:group A(n=14),group B(n=12),group C(n=10).T_1 and T_2 values were measured by Siemens workstation in residual liver parenchyma of HAE group and in liver parenchyma of control group. The variance analysis was used to compare the T_1 and T_2 values between the four groups.Results:The measurements of T_1 and T_2 average values were as below:control group [T_1(338.9±95.6)ms,T_2(42.7±3.1)ms];group A [T_1(393.47±158)ms,T_2(43.74±5.3)ms];group B [T_1(351.5±84.7)ms,T_2(57.85±7.7)ms];group C [T_1(460.9±76.0)ms,T_2(65.9±3.0)ms].There was no statistically significant difference found in T_1 values between the 4 groups(P>0.05).However,T_2 values were statistically significant differences between the control group and group B and C(P<0.05),and between group A and B and C(P<0.05),however,but no significant difference in T_2 velues between healthy group and group A(P>0.05).Conclusion:T_2-mapping sequence may be useful for the assessment of liver function of HAE,while T_1-mapping sequence still need to investigate.
引文
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[13] 李绍林,张雪林,朱幼芙,等.磁共振成像T1值、T2值和ADC值与肝脏纤维化模型病理评分分级纤维化分期诊断结果相关性研究[J].医学影像学杂志,2009,19(1):56-60.
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[15] 殷亮,喻思思,龚良庚.磁共振T1-mapping在心脏疾病中的应用[J].放射学实践,2016,31(6):546-549.
[16] 汪苍,刘晓蕾,米瑞,等.磁共振T1-mapping、T2-mapping和BOLD对大鼠肝纤维化分期定量诊断价值的比较[J].临床放射学杂志,2018,37(2):341-345.
[2] Wen H,Dong JH,Zhang JH,et al.Ex vivo liver resection and autotransplantation for end-stage alveolar echinococcosis:a case series[J].Am J Transplant,2016,16(2):615-624.
[3] Reddy SS,Civan JM.From Child-Pugh to model for end-stage liver disease:deciding who needs a liver transplant[J].Med Clin North Am,2016,100(3):449-464.
[4] 李莉,唐鹤菡,刘洋洋,等.Gd-EOB-DTPA增强MRI定量评估肝脏储备功能的可行性研究[J].放射学实践,2016,31(1):19-25.
[5] Tong C,Xu X,Liu C,et al.Assessment ofliver volume varlation to evaluate liver function[J].Front Med,2012,6(4):421-427.
[6] 潘华锋,陈孝平,邹明丽,等.CT检查预测肝癌手术切除安全性的价值[J].肝胆外科杂志,2000,8(3):185-187.
[7] He YB,Bai L,Aji T,et al.Application of 3D reconstruction for surgical treatment of hepatic alveolar echinococcosis[J].World J Gastroenterology,2015,21(35):10200-10207.
[8] Kamimura K,Fukukura Y,Yoneyama T,et al.Quantitative evaluation of liver function with T1 relaxation time index on Gd-EOB-DTPA-enhanced MRI:comparison with signal intensity-based indices[J].J Mag Reson Imaging,2014,40(4):884-889.
[9] Ding Y,Rao SX,Chen C,et al.Assessing liver function in patients with HBV-related HCC:a comparison of T1-mapping on Gd-EOB-DTPA-enhanced MR imaging with DWI[J].Eur Radiol,2015,25(5):1392-1398.
[10] 张小彪,马菁,郭玉林,等.3.0T磁共振对肝硬化背景上小肝癌检出的价值[J].临床放射学杂志,2014,33(8):1193-1197.
[11] Gottstein B,Haag K,Walker M,et al.Molecular survival strategies of Echinococcus multilocularis in the murine host[J].Parasitol Int,2006,55(Suppl):S45-S49.
[12] 张传山,王俊华,吕国栋,等.泡球蚴感染对宿主肝细胞增殖影响的初步研究[J].中华肝脏病杂志,2013,21(3): 228-233.
[13] 李绍林,张雪林,朱幼芙,等.磁共振成像T1值、T2值和ADC值与肝脏纤维化模型病理评分分级纤维化分期诊断结果相关性研究[J].医学影像学杂志,2009,19(1):56-60.
[14] Besa C,Bane O,Jajamovich G,et al.3D T1 relaxometry pre and post gadoxetic acid injection for the assessment of liver cirrhosis and liver function[J].Magn Reson Imaging,2015,33(9):1075-1082.
[15] 殷亮,喻思思,龚良庚.磁共振T1-mapping在心脏疾病中的应用[J].放射学实践,2016,31(6):546-549.
[16] 汪苍,刘晓蕾,米瑞,等.磁共振T1-mapping、T2-mapping和BOLD对大鼠肝纤维化分期定量诊断价值的比较[J].临床放射学杂志,2018,37(2):341-345.
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