摘要
目的探讨动态增强磁共振(DCE-MRI)定量参数评估儿童先天性胆总管囊肿(CCC)所致肝纤维化的价值。方法纳入33例CCC致肝纤维化患儿(病例组),以14例无肝肾疾患儿童为对照组。采集肝脏DCE-MRI后,拟合Tofts模型,获得参数K trans、K ep及V e,观察不同肝纤维化分期定量参数差异及其相关性,以ROC曲线分析各参数诊断肝纤维化的AUC和最佳截界值。结果K trans、K ep在不同纤维化亚组间差异均有统计学意义(P均<0.05),且随肝纤维化程度增加而下降(r=-0.764、-0.720,P均<0.05);V e在不同纤维化亚组中差异无统计学意义(P>0.05),与肝纤维化程度无明显相关(r=-0.249,P>0.05)。K trans、K e判别正常与肝纤维化、轻度与重度肝纤维化的AUC分别为0.949、0.748和0.933、0.731,截界值分别为0.239、0.186和1.814、1.663。结论DCE-MRI定量灌注参数K trans、K ep对诊断儿童CCC致肝纤维化及其分期具有一定价值。
Objective To investigate the value of dynamic contrast enhanced MRI(DCE-MRI)quantitative parameters for evaluation of liver fibrosis caused by pediatric congenital choledochal cyst(CCC).Methods Totally 33 CCC children with liver fibrosis were included into case group,while 14 children were selected as control group.All children underwent liver DCE-MRI.Quantitative parameters were acquired with Tofts model,including volume transfer constant from blood plasma to extravascular extracellular space(K trans),transfer rate constant between extravascular extracellular space and blood plasma(K ep)and volume of extravascular extracellular space(Ve).The differences and correlations of the above parameters among different liver fibrosis stages were analyzed,and AUC of each parameter in diagnosing different grades of liver fibrosis were drawn.Results K trans and K ep were significantly different among fibrosis subgroups(all P<0.05),which decreased with liver fibrosis progressed(r=-0.764,-0.720,both P<0.05).V e showed no statistical significant difference among three subgroups(P>0.05)and negative correlation with liver fibrosis staging(r=-0.249,P>0.05).AUC for identifying normal vs fibrosis and mild vs advanced fibrosis by K trans and K ep were 0.949,0.748 and 0.933,0.731,and the cutoff values were 0.239,.0.186 and 1.814,1.663,respectively.Conclusion DCE-MRI perfusion parameters such as K trans and K ep are valuable for diagnosing and staging of liver fibrosis caused by CCC in children.
作者
易盈
金科
陈文坚
向永华
蔡齐芳
YI Ying;JIN Ke;CHEN Wenjian;XIANG Yonghua;CAI Qifang(Department of Radiology,Hunan Children's Hospital,the Paediatric Academy of University of South China,Changsha 410007,China)
出处
《中国医学影像技术》
CSCD
北大核心
2020年第3期420-424,共5页
Chinese Journal of Medical Imaging Technology
基金
湖南省医药卫生科学技术研究项目(B2017112)。
关键词
肝硬化
血流动力学
胆总管囊肿
磁共振血管造影术
liver cirrhosis
hemodynamics
choledochal cyst
magnetic resonance angiography
