摘要
目的运用磁共振相位对比法（PC-MRI）对门静脉系统血流参数进行测量,探讨PC-MRI在乙肝肝硬化肝功能状况评价中的应用价值及意义。方法 40例乙肝肝硬化患者,男32例,女8例,年龄29-70岁,平均52.3岁,其中Child-Pugh A级15例,B级13例,C级12例;10例对照组患者,男6例,女4例,年龄40-60岁,平均42岁。通过PC-MRI测量门静脉、肠系膜上静脉及脾静脉的截面积（S,mm^2）、平均血流量（Q,ml/s）和平均流速（V,cm/s）。结果对照组门静脉截面积（SPV）明显小于肝硬化各组（P〈0.05）;随着肝硬化程度的加重,门静脉平均血流量（QPV）和平均流速（VPV）逐渐减小（P〈0.05）,Child-Pugh C级的VPV明显低于Child-Pugh A、B级（P〈0.05）;肝硬化各组肠系膜上静脉截面积（SSMV）明显高于正常组（P〈0.05）,Child-Pugh B级低于Child-Pugh A、C级（P〈0.05）;Child-Pugh B、C级SSV较正常组明显增大,且差异具有统计学意义（P〈0.05）。QPV、VPV、脾静脉平均血流量（QSV）和脾静脉平均流速（VSV）与MELD评分呈负相关（P〈0.05）,相关系数分别为-0.396、-0.464、-0.453、-0.549。结论 PC-MRI可有效评价乙肝肝硬化不同肝储备功能状态的门静脉系统血流状态,是评价肝硬化严重程度及肝脏储备功能的重要影像学手段。
Objective To measure portal flow parameters by using phase-contrast magnetic resonance imaging （PC- MRI） in order to investigate the value of PC-MRI in assessing the liver function in patients with cirrhosis. Methods A total of 40 patients with hepatitis B cirrhosis （ study group） , including 32 males and 8 females with a mean age of 52.3 years （29 -70 years）, were included in this study. Of the 40 patients, Child-Pugh class A was seen in 15, class B in 13 and class C in 12. Other 10 patients who had no liver diseases, including 6 males and 4 females with a mean age of 42 years （40 -60 years）, were collected as the control group. PC-MRI was performed in all patients. The cross-sectional area （ S, mm^2 ）, the mean flow volume （ Q, ml/min） and the mean velocity （ V, cm/s） of the portal vein （ PV）, superior mesenteric vein （ Suv ） and splenic vein （SV） were calculated. Results Spy of the control group was significantly lower than that of the cirrhosis group （P 〈 0.05 ）. With the aggravation of liver cirrhosis degree, QPv and Vpv gradually decreased （ P 〈 0.05 ）. Vpv in Child-Pugh class C was obviously lower than that in Child-Pugh class A as well as in Child-Pugh class B （ P 〈 0.05 ）. Ssuv of the study group, regardless of the Child-Pugh classifications, was significantly higher than that of the control group （ P 〈 0.05 ）. In the study group, SSMv of Child-Pugh class B was significantly lower than that of Child-Pugh class A and C （ P 〈 0.05 ）. Ssv of Child-Pugh class B and C was larger than that of the control group, and the difference was statistically significant （ P 〈 0.05 ）. The flow parameters, including Qpv, Vpv Qsv and Vsv, bore a negative correlation with MELD score, the correlation coefficients being - 0. 396, - 0. 464, - 0. 453, - 0. 549 respectively （ P 〈 0.05 ）. Conclusion PC-MRI can effectively evaluate the hemodynamic state of portal vein system in hepatitis B cirrhosis patients with different liver reserve function. Therefore, PC-MRI is an important means for the evaluation of the severity of cirrhosis and liver reserve function.
出处
《临床放射学杂志》
CSCD
北大核心
2015年第4期567-571,共5页
Journal of Clinical Radiology
基金
国家自然科学基金项目(编号:61061005
61440043)
