动态对比增强磁共振成像对急性胰腺炎血流灌注的研究

目的研究动态对比增强磁共振成像(dynamic contrast enhanced MRI,DCE-MRI)对急性胰腺炎(acute pancreatitis,AP)的诊断价值。材料与方法本研究获得我院伦理委员会批准,受检者均签署知情同意书。搜集我院经临床确诊的AP患者45例及对照组20例。使用3.0 T磁共振对所有患者行T1WI、T2WI、脂肪抑制T2WI、多反转角T1WI-LAVA及T1WI-LAVA动态对比增强扫描序列,并通过Omni-Kinetics Version V2.0.10后处理软件Omitk DCEMRITool工具对多反转角T1WI-LAVA及T1WI-LAVA动态对比增强图像进行后处理,获得AP与对照组胰腺DCE-MRI灌注参数Ktrans、Vp、AUC值。用Wilcoxon符号秩和检验比较对照组胰头、体、尾灌注参数两两之间的差异。用Wilcoxon秩和检验比较对照组与AP组灌注参数的差异。结果 AP组的Ktrans、Vp、AUC值分别为(0.417,0.132~0.746)ml/min、(0.058,0.028~0.12)、(4.467,3.594~7.447);对照组胰腺的Ktrans、Vp、AUC值分别为(0.762,0.389~0.918)ml/min,(0.222,0.111~0.347),(6.597,4.646~9.226)。AP组胰腺的Ktrans、Vp,AUC值低于对照组,且差异有统计学意义(P均0.05)。对照组胰头、体、尾的Vp值两两比较差异无统计学意义(P均0.05),对照组胰头的Ktrans值、AUC值要高于胰体与胰尾,且差异有统计学意义(P均0.05),而胰体与胰尾的Ktrans值、AUC值的差异无统计学意义(P均0.05)。结论 DCE-MRI可无创、无辐射的量化评估胰腺微循环灌注情况,从而为进一步研究AP灌注奠定理论和实践基础。

Dynamic contrast enhanced MRI for pancreatic perfusion in acute pancreatitis

Objective:To study dynamic contrast enhanced MRI (DCE-MRI) for the normal pancreas and acute pancreatitis (AP).Materials and Methods:The institutional review board approved the study,written informed consent was obtained.Twenty patients without any pancreatic disorders (control group) and forty five patients with clinically proved AP were recruited in this study.All patients had performed MRI with T1WI,T2WI,fat suppression T2WI sequences,multiple flip angle T1WI-LAVA and T 1WI-LAVA dynamic contrast enhanced scan sequence.The OmitkDCEMRITool of Omni-Kinetics Version V2.0.10 (GE) was used to analyze the multiple flip angles T1WI-LAVA and T1WI-LAVA dynamic contrast enhanced imagings.The Ktrans,Vp and AUC values were measured in both AP group and Control group.The perfusion parameters of the head,body and tail of normal pancreas were compared by using the Wilcoxon singned-rank test,and the perfusion parameters of AP group and Control group were compared by Wilcoxon rank sum test.Results:The Ktrans,Vp and AUC values of AP were (0.417,0.132-0.746) ml/min,(0.058,0.028-0.12) and (4.467,3.594-7.447),respectively.The Ktrans,Vp and AUC values of normal pancreas were (0.762,0.389-0.918) ml/min,(0.222,0.111-0.347),(6.597,4.646-9.226),respectively.The Ktrans,Vp and AUC values of AP were lower than those of control group (all P＜0.05).The Vp value of normal pancreas was no statistically significant difference among the head,body and tail (all P＞0.05).The Ktrans and AUC values of normal pancreas were statistically significant difference between the head and body (all P＜0.05),as well as between the head and tail (all P＜ 0.05).But no statistical difference was found between the body and tail (all P＞0.05).Conclusions:DCE-MRI can quantify the microcirculation perfusion of the pancreas with noninvasive and no radiation,and lay the foundations of theory and practice for further study the AP perfusion.