三维全肝MRI动态增强扫描定量分析在肝脏肿瘤诊断中的应用
The application of the quantitative analysis of three-dimensional whole-liver DCE-MRI in the diagnosis of hepatic tumors
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摘要: 目的：研究肝细胞肝癌（HCC）、肝转移瘤（HM）和肝血管瘤（HH）患者的肝动脉灌注指数（HPI）以及血管渗透性参数，探讨三维全肝MRI动态增强扫描定量分析在鉴别诊断肝脏肿瘤中的价值。方法：选取58例受检者（HCC组30例，HM组16例，HH组12例），采用三维容积内插体部检查（VIBE）序列进行全肝磁共振动态增强扫描（DCE-MRI），并用Omni-Kinetics软件分析图像，结合肝脏双输入血流动力学模型获得肝脏灌注和血管渗透性参数HPI、容积转运常数（Ktrans）、回流速率常数（kep）、血管外细胞外间隙体积比（ve）值和血浆空间容积率（vp）。结果：3组HPI值、Ktrans和kep值差异均有统计学意义（P < 0.05～P < 0.01）；HPI值HCC组 > HH组 > HM组（P<0.05）；Ktrans值HCC组 > HH组 > HM组（P < 0.05～P < 0.01）；kep值HCC组>HH组和HM组（P<0.01），但HH组和HM组的kep值差异无统计学意义（P>0.05）；3组ve和vp值差异均无统计学意义（P>0.05）。结论：三维全肝DCE-MRI扫描可获得定量血流灌注及血管渗透性参数，有助于肝脏肿瘤的鉴别诊断。Abstract: Objective: To investigate the hepatic perfusion index(HPI) and vascular permeability parameters in patients with different hepatic tumors,which included hepatocellular carcinoma(HCC),hepatic metastasis(HM) and hepatic haemangiomas(HH),and discuss the clinical diagnosis value of DCE-MRI.Methods: Fifty-eight patients with hepatic tumors(30 cases of HCC,16 cases of HM and 12 cases HH) were detected by the 3D whole-liver dynamic contrast enhance MRI(DCE-MRI) using volumetric interpolated body examination(VIBE) sequence.The perfusion and vascular permeability parameters(including HPI,Ktrans,kep,ve and vp) were measured by the Omni-Kinetics software combined with liver model of dual input hemodynamics.Results: There was statistical difference in the values of HPI,Ktrans and kep between three groups(P<0.05 to P<0.01).The HPI value in HCC group was significantly higher than that in HH group,and the HPI value was the lowest in HM group(P<0.05).The Ktrans value in HH group was significantly lower than that in HCC group,and the value was the lowest in HM group(P<0.05 to P<0.01).The kep value in HCC group was higher than that in HH and HM groups(P<0.01),but there was no statistical difference between HH and HM groups(P>0.05).The differences of the vp and ve values between three groups were not statistically significant(P>0.05).Conclusions: Three-dimensional whole-liver DCE-MRI with the bolus injection of gadodiamide can be used to quantify the perfusion and permeability parameters of hepatic tumors,which is benefit to the differentiation diagnosis of hepatic tumors.
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Key words:
- hepatic tumor /
- magnetic resonance imaging /
- liver /
- dynamic contrast enhancement
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