摘要
目的探讨扩散张量成像（DTI）磁共振成像（MRI）对兔肝热缺血-再灌注损伤的应用价值。方法健康成年新西兰大白兔20只，随机选取10只夹闭肝动脉和门静脉30 min，再灌注6 h建立肝热缺血-再灌注损伤兔模型，另10只作为正常对照组。所有实验兔于Siemens MAGNETOM Trio Tim 3.0T MR行DTI MRI扫描，采集数据后用Siemens Nero 3D进行后处理，由2位经验丰富的影像专业医师分别测量兔肝表观扩散系数（ADC）、各向异性分数（FA）值，并使用组内相关系数（ICC）检验其一致性，观察是否具可重复性。磁共振（MR）检查后立即处死实验兔，经耳缘静脉取血检测血清丙氨酸转氨酶（ALT）、天冬氨酸转氨酶（AST）、血清乳酸脱氢酶（LDH）水平；取冻存肝组织检测其总超氧化物歧化酶（SOD）、丙二醛（MDA）及髓过氧化酶（MPO）水平。采用两独立样本t检验比较组间ADC、FA值之间差异，组间临床化验指标差异采用非参数Mann-Whitney U检验，应用Spearman相关分析评价ADC值与临床化验指标的相关性，应用受试者工作特征（ROC）曲线评价ADC值诊断效能。结果两名观察者所测ADC、FA值具有较高的一致性，ICC值分别为0.890、0.823。热缺血-再灌注损伤组和正常组兔肝的ADC值差异有统计学意义（P＝0.000），分别为（1.46±0.14）×10^－3 mm^2/s、（1.83±0.20）×10－3 mm2/s，而FA值组间差异无统计学意义，分别为0.38±0.03、0.37±0.04（P＝0.664）。两组间ALT、AST、LDH、总SOD、MDA及MPO之间差异均有统计学意义（P＝0.000）。ADC值与ALT、AST、LDH、MPO及MDA之间均呈负相关（P＝0.041、0.004、0.001、0.001、0.012），ADC值和总SOD之间呈显著正相关（r＝0.782，P＝0.000）。ADC值评价兔肝热缺血-再灌注损伤具有较高的诊断效能[曲线下面积（AUC）＝0.97]，其最佳诊断阈值为1.676×10^－3 mm^2/s，灵敏度为90%，特异度为100%。结论DTI MRI�
Objective Investigating the application value of diffusion tensor imaging （DTI） magnetic resonance imaging （MRI） in hepatic warm ischemia-reperfusion injury （WIRI） in rabbits.Methods 10 out of 20 healthy adult New Zealand white rabbits were randomly chosen to establish the model of hepatic WIRI after ischemia for 30 minutes and 6 hours of reperfusion, and the remaining 10 rabbits were chosen as the normal control group. All the experimental rabbits were scanned with MAGNETOM Trio Tim 3.0T MRI DTI MR Siemens and the data were collected by using Nero 3D Siemens. The apparent diffusion coefficient （ADC）, fractional anisotropy （FA） values were separately measured by 2 qualified radiologist. Then, we use intra-class correlation coefficient （ICC） to check their consistency and repeatability. Experimental rabbits were killed immediately after magnetic resonance （MR） examination and routine assays were performed for testing the levels of alanine aminotransferase （ALT）, aspartate aminotransferase （AST）, lactate dehydrogenase （LDH） through the ear vein blood serum; the contents of the total superoxide dismutase （SOD）, malondialdehyde （MDA） and myeloperoxidase （MPO） in liver tissue. Two independent samples t were used to compare the in-group difference between FA and ADC values. The difference of clinical laboratory parameters between groups was analyzed by non-parametric U Mann-Whitney test. The correlation between ADC value and clinical test index was evaluated by Spearman correlation analysis. The ADC value was evaluated by ROC curve.Results The ADC and FA values measured by the two observers have high consistency with two ICC values 0.890 and 0.823 respectively. The ADC differences between the warm ischemia-reperfusion injury group and the normal group have statistical significance （P=0.000）, which are （1.46±0.14）×10^-3 mm^2/s, （1.83±0.20）×10^-3 mm^2/s respectively. However, the FA value difference does not have statistical significant, which are （0.3
作者
于文娟
季倩
褚志强
任涛
许诗超
沈文
Yu Wenjuan, Ji Qian, Chu Zhiqiang, Ren Tao, Xu Shichao, Shen Wen(Department of Radiology, Tianjin First Central Hospital, Tianjin 300192, China;Department of Transplant, Tianjing First Central Hospital, Tianjin 300192, China)
出处
《中华实验外科杂志》
CAS
CSCD
北大核心
2018年第3期420-423,共4页
Chinese Journal of Experimental Surgery
基金
国家自然科学基金（81301197）
关键词
扩散张量成像
肝热缺血-再灌注损伤
肝脏
兔模型
Diffusion tensor imaging
Hepatic warm ischemia-reperfusion injury
Liver
Rabbit model
