磁共振成像定量门静脉高压症血流动力学改变与门静脉压力相关性研究

目的采用电影相位对比磁共振成像（MRI）定量测量肝硬化门静脉血流,评价其与术中门静脉压力相关性。方法 34例肝硬化门静脉高压患者为肝硬化组,男21例,女13例;平均年龄48.6岁;采用电影相位对比MRI对34例门静脉高压症患者术前1周行门静脉血流定量测量,术中测量门静脉压力。对照组为性别比、年龄与肝硬化组匹配的健康志愿者19例。结果肝硬化组门静脉主干截面积与对照组比较均显示显著性增大（P〈0.05）,肝硬化组门静脉血流量为（21.71±12.42）cm3/s,与正常组比较明显增高（P〈0.05）,肝硬化组流速较正常对照组略减低,但差异无统计学意义（P〉0.05）。34例门静脉高压患者术中测压,门静脉压力明显增高,为（33.79±5.32）cm H2O柱,门静脉流量与压力行pearson相关性分析,无明显相关性（r=0.293,P〈0.01）。结论电影MRI肝硬化术前门静脉血流定量可客观显示门静脉系统呈高血流动力学改变,门静脉压力亦可以反映肝硬化严重程度,但门静脉血流量与压力无明显相关性。

The relationship between hemodynamic changes by MRI and portal vein pressure in cirrhosis patients with portal hypertension

Objective To investigate the hemodynamic changes by MRI in cirrhosis patients with portal hypertension and to study their relationship between the flow parameter and pressure of portal vein.Methods 34 patients including 21males and 13 females(mean age:48.6 years) were enrolled in the study.19 healthy subjects were served as controls.The portal hemodynamic changes were detected by Cine PC MRI.The portal vein pressure was tested during operation.Results The area section of main portal vein in portal vein hypertention group was significantly larger than that in control group(P<0.05).The flow of portal vein(21.71±12.42)cm3/s in patients with potal hypertention was significantly larger than that in control group(P<0.05).The velocity of portal vein of patients was slower than that in control group(P>0.05).The portal vein pressure was(33.79±5.32)cm H2O in patients during operation.The portal vein pressure was not correlated with Qpv(r=0.293,P<0.01).Conclusion The quantitative detection of portal vein flow before cirrhosis operation by PC MRI can show objectively the high hemodynamic levels in portal system,and portal vein pressure can reflect the severity of cirrhosis,however,portal vein flow is not correlated with portal vein pressure.