摘要
目的:探讨多模态影像技术对大鼠肝纤维化(HF)的评估价值。方法:选取健康雄性(SD)大鼠48只,采用随机数表法将其均分为对照组、M1模型组、M2模型组和M3模型组,共4组,每组12只。M1、M2和M3模型组采用四氯化碳(CCl4)加乙醇复合法进行诱导,制备肝纤维化模型。分别在造模第4、6和8周时,M1模型组进行超声检测,M2模型组进行动态增强磁共振影像(DCE-MRI)检测,M3模型组采用常规超声、超声弹性成像联合DCE-MRI技术检测。对照组大鼠随机分为3组,每组4只,分别与M1、M2、M3组大鼠进行对照。影像检查结束后取肝组织行HE染色,观察模型组大鼠肝脏纤维化的程度。采用常规超声观察大鼠肝脏形态,测量门静脉主干内径。彩色多普勒测量门静脉血流速度。超声弹性观察肝实质硬度颜色分布、测量肝脏实质的弹性值。采用受试者工作特征(ROC)初始曲线下面积(iAUC)分析DCE-MRI检查中血流动力参数容量转运常数(Ktrans)、速率常数(Kep)和血管外细胞外间隙体积百分数(Ve)的诊断效能。结果:常规超声显示,对照组大鼠肝脏无异常变化,M1组大鼠肝脏形态发生改变。超声弹性成像显示:M1组大鼠肝脏弹性值(33.16kPa)随着纤维化程度的加重而呈上升趋势,且高于对照组(13.11kPa)。M2组常规MRI显示:对照组大鼠肝脏形态正常,M2组中,造模6与8周大鼠较4周大鼠肝脏形态改变更明显。DCE-MRI结果中的ROC曲线分析显示,Ktrans与Ve对肝纤维化具有较高的诊断效能,其iAUC均>0.9。M1模型组、M2模型组、M3模型组大鼠进行组间比较,多模态影像技术对大鼠早期肝纤维化诊断的灵敏度、准确率、阳性预测值、阴性预测值均高于单独的检查手段,差异有统计学意义(χ^(2)=0.634、0.644、0.621、0.543,P<0.05)。HE染色结果显示,模型组大鼠肝组织出现不同程度的纤维增生。结论:多模态影像技术可以作为评价肝脏纤维化的有效检测方法。
Objective:To explore the assessment value of multimodal imaging technique for the hepatic fibrosis(HF)of rats.Methods:Forty-eight SD rats were selected,and they were divided into control group,M1 model group,M2 model group and M3 model group according to random number table,with 12 rats in each group.The three model groups were induced by combination method of carbon tetrachloride(CCl4)plus ethanol to establish HF model.At the 4th,6th and 8th week of modelling,the M1 model group underwent ultrasound examination,and the M2 model group underwent examination of magnetic resonance,and the M3 model group adopted the examinations of conventional ultrasound,ultrasound elastography and dynamically contrast enhanced magnetic resonance imaging(DCE-MRI).The rats of control group were randomly divided into three subgroups,with four rats in each subgroup,which were controlled with the rats in the M1,M2 and M3 groups,respectively.At the end of the imaging examinations,the HE staining were conducted on the liver tissues so as to observe the HF degree of rats.The conventional ultrasound was used to observe the morphology of the rat liver,and to measure the inner diameter of the main trunk of the portal vein.colour Doppler ultrasound was used to measure the blood flow velocity of portal vein.Ultrasound elastography was used to observe the color distribution of liver parenchymal stiffness,and to measure the elasticity value of liver parenchyma.The initial area under curve(iAUC)of the receiver operating characteristic(ROC)was adopted to analyze the volume transit constant(Ktrans),rate constant(Kep)and extravascular extracellular space volume fraction(Ve)of the hemodynamic parameters in enhanced magnetic resonance examination.Results:The conventional ultrasound showed there was no abnormal changes in the livers of rats in control group,and the morphology of the liver of M1 group occurred changes.Ultrasound elastography showed that the elasticity values of the liver of rats in M1 group appeared upward trend with the aggravation of the HF degree than control group.Conventional MRI of group M2 showed that the liver morphology was normal in the control group,and the changes of the liver morphologies of rats in M2 group at the 6th and 8th week post modeling were more obvious than that at the 4th week post modeling.The ROC curve analysis of DCE-MRI results showed that Ktrans and Ve had higher diagnostic efficacy for HF,and their iAUC values were>0.9.The results of intergroup comparison of rats among M1 model group,M2 model group and M3 model group indicated that the sensitivity,accuracy,positive predictive value and negative predictive value of multimodal imaging technique were significantly higher than those of single examination in diagnosing HF at early stage of rats,and the differences were statistically significant(χ^(2)=0.634,0.644,0.621,0.543,P<0.05),respectively.HE staining results showed that the liver tissues of the rats in the model groups appeared fibroplasia of different degrees.Conclusion:Multimodal imaging technique can be used as an effective test method of evaluating hepatic fibrosis.
作者
姜帆
刘进忍
田洪达
李春香
李国华
李忠原
Jiang Fan;Liu Jinren;Tian Hongda;Li Chunxiang;Li Guohua;Li Zhongyuan(Department of Nuclear Medicine,The First Affiliated Hospital of Qiqihar Medical College,Qiqihar 161041,China;Department of Physical Diagnosis,Qiqihar Infectious Disease Prevention and Control Hospital,Qiqihar 161000,China)
出处
《中国医学装备》
2024年第6期183-188,共6页
China Medical Equipment
基金
黑龙江省齐齐哈尔市科技计划联合引导项目(LSFGG-2022066)。
关键词
肝纤维化
超声弹性成像
动态增强磁共振成像(DCE-MRI)
Hepatic fibrosis
Ultrasound elastography
Dynamically contrast enhanced magnetic resonance imaging(DCE-MRI)
