弥散加权成像诊断兔急性肝缺血再灌注损伤

目的 探讨3.0T MR DWI对兔急性肝脏缺血再灌注损伤(IRI)的诊断价值。方法 新西兰大白兔24只,将其中18只兔制成IRI模型,结扎肝左叶血供60 min后恢复血供,随机分为0.5 h、2 h和6 h组,每组6只;另外6只作为对照组,仅解剖肝十二指肠韧带,未阻断血供。b值分别选取100、200、300、500、600 s/mm²,行T2W、T1W、增强T1W检查,并进行组织病理学检查。结果 IRI后0.5 h,T2WI和DWI表现为整个肝左叶信号增高,在2 h和6 h时出现点片状高信号以及相对应的强化减低区。b=100、200、300 s/mm²时,0.5 h组ADC值明显低于对照组(P<0.05);2 h组ADC值虽有升高(b≤300 s/mm²较明显),但与对照组间差异无统计学意义(P＞0.05);b=100 s/mm²时,6 h组与对照组间差异有统计学意义(P<0.05)。镜下表现:IRI早期肝细胞弥漫性肿胀、肝窦内、中央静脉及小动脉内大量红细胞淤积。随着损伤加重,肝窦及肝实质内中性粒细胞浸润,肝细胞核固缩凋亡,肝窦解离。结论 应用较小b值(b≤300 mm²/s),3.0T DWI能反映兔肝脏IRI早期阶段的肝血窦淤血等微循环障碍的病理生理过程,对于早期动态监测、预防肝脏IRI具有重要临床意义。

Diffusion weighted imaging assessment of acute hepatic ischemia reperfusion injury in rabbit models

Objective To explore the value of DWI in assessment of acute hepatic ischemia reperfusion injury(IRI) in rabbit models.Methods IRI models were established in 18 New Zealand white rabbits.The rabbit models were then divided into three groups(including 0.5 h,2 h and 6 h group,each n=6),undergoing 60 min's left lobar ischemia and following 0.5,2 and 6 h reperfusion.The rest 6 rabbits were taken as control group without liver ischemia-inducing.DWI using b values of 100,200,300,500 and 600 s/mm2 was performed wi...