电影相位对比与屏气二维相位对比MRI对肝硬化门静脉血流的对照研究

目的探讨MRI电影法相位对比（Cine PC）与屏气二维相位对比（2D PC）在肝硬化患者和正常志愿者门静脉血流测量中的诊断价值。资料与方法对照组为82名志愿者,男45名,女37名,平均年龄26.65岁;肝硬化组24例,男14例,女10例,平均年龄42.00岁。空腹状态下采用CinePC技术对门静脉血流定量测量,同期采用2DPC技术3种不同屏气状态（正常吸气屏气,呼气屏气,平静呼吸屏气）与其进行比较。结果肝硬化患者门静脉血流速度较对照组略减低,除2D PC平静呼吸法,余方法两组差异均无统计学意义,肝硬化组门静脉血流量与对照组比较明显增大（P〈0.01）,但2DPC吸气屏气技术两者差异无统计学意义。采用相关性分析对屏气2DPC（不同呼吸状态）与Cine PC MRI方法定量门静脉血流速度、血流量,显示两种技术相关性很好（r〉0.8;P〈0.01）,但在对照组行相关性分析,仅呼气后屏气2D PC与Cine PC显示中度相关（r〉0.5;P〈0.01）,吸气后屏气与CinePC相关性较差（r〈0.4）。结论MRI Cine PC在正常呼吸情况下对门静脉血流行定量测量,接近人体生理状态,适合门静脉血流测量;正常呼吸状态屏气对肝硬化患者门静脉血流影响较正常人小,在肝硬化血流测量中,MRI Cine PC与屏气2DPCMRI法显示很好相关性。屏气2DPCMRI技术提供了一种简便、实用、相对准确的肝硬化门静脉血流测量方法。

Portal Venous Blood Flow Quantitative Study with Breath-holding 2D PC and Cine PC MRI in Controls and Cirrhotics

Objective To investigate the diagnostic value of flow velocity and volume in the main portal vein with 2D PC and cine PC MRI in healthy controls and cirrhotics.Materials and Methods 82 healthy controls,45 males and 37 females,mean age 26.65 years old,24 patients with cirrhotics(14 males and 10 females),with mean age 42.00 years old.The results of blood flow in the main portal vein under basal fasting conditions by using the cine phase-contrast MRI and 2D PC MRI with breath-holding(BH)in three types including normal inspiration and normal expiration and eupnea were compared.Results Portal venous blood flow velocity in controls and cirrhotics showed no significant difference except BH after eupnea.However,when the volume of portal vein were compared in controls with cirrhotics,there were obviously significant difference(P<0.01),except breath-holding after inspiration.In patients group the blood flow measurement showed positive correlation between cine and different types BH 2D PC MRI(r>0.8).In controls,portal blood flow measurement with cine and BH 2D PC MRI showed moderate correlation in 2D PC after breath-holding of eupnea(r>0.5).Conclusion Portal blood flow measurements using Cine PC MRI closely reflect physiologic conditions.As the respiration-induce hemodynamic variation in portal blood flow is less in cirrhotics than that in the healthy controls.Because of the well correlation between the BH and cine PC MRI in flow volume and velocity,the BH 2D PC may be a time-saving method to measure flow velocity and volume in the main portal vein in cirrhotics.