电影相位对比磁共振评估肝硬化门静脉血流动力学研究

目的基于电影相位对比磁共振测量门静脉血流动力学指标,探讨其与门静脉高压之间的关系。方法 21例健康成人及45例肝硬化门静脉高压患者,均行电影相位对比磁共振检查。两名放射科医生分别独立测量门静脉主干横截面积和流速;其中45例肝硬化门静脉高压患者在经颈静脉肝内门体分流术（TIPSS）中测量并记录门静脉压力。分别比较肝硬化合并上消化道出血组、肝硬化无上消化道出血组及正常健康成人组门静脉横截面积和流速,对肝硬化患者门静脉压力与门静脉横截面积、流速的相关性进行分析。统计学采用单因素方差分析和Pearson相关分析,p〈0.05,有显著性差异。结果肝硬化组门静脉主干横截面积大于对照组,流速低于对照组,二者统计学均有显著性差异（P〈0.05）;肝硬化合并上消化道出血与无上消化道出血组门静脉横截面积、血流速度均无显著性差异（P〉0.05）。Pearson相关性分析示肝硬化患者门静脉压力与门静脉横截面积呈弱的正相关（r=0.404）,与门静脉流速呈负的中度相关（r=-0.534）。结论电影相位对比磁共振可以客观反映肝硬化患者门静脉血流动力学改变。

Cine Phase Contrast Magnetic Resonance Imaging Assessment of Liver Cirrhosis Portal Venous Blood Flow Dynamics Research

Objective Objective To evaluate the relationship between portal hypertension and portal hemodynamic parameters measured by cine phase-contrast magnetic resonance. MethodsA total of 21 healthy volunteers and 45 patients with hepatic cirrhosis were acquired cine phase-contrast magnetic resonance by 1.5 Tesla scanner. The cross-sectional area of portal vein and the blood flow velocity of portal vein were measured by two radiologists, respectively. Then the portal venous pressures of patients were measured during TIPSS surgery. Diameter and velocity of portal vein in hepatic cirrhosis groups with or without upper gastrointestinal hemorrhage and healthy volunteers were analyzed by one-way ANOVA test. Moreover, the correlations between pressures, areas and flow velocity of portal venous in the hepatic cirrhosis populations were assessed by Pearson＇s correlation test. Results The portal vein area of patients were significantly larger than normal volunteer＇s（P〈0.05） and the blood flow velocity of patients were significantly slower than volunteer＇s,（P〈0.05）. In the cirrhosis patients, there were no significant difference in portal vein area and blood flow velocity between upper gastrointestinal hemorrhage and no-upper gastrointestinal hemorrhage patients（P〉0.05）. According to Pearson＇s analysis, there was weak positive correlation between pressures and area of portal vein（r=0.404）, however, a moderate inverse correlation was found between pressures and velocity of portal vein（r=-0.534）. Conclusion Cine phase-contrast magnetic resonance can reflect the portal hemodynamic parameters of cirrhosis patients objectively.