CAJ | 학술논문

目的：通过大鼠模型比较并评估常规DWI和DTI肝纤维化及早期肝硬化的临床鉴别诊断的价值。材料与方法采用经典四氯化碳方法建立SD大鼠肝纤维化模型7只、早期肝硬化模型5只，正常对照组6只(该实验经实验动物伦理委员会批准)。采用1.5 T超导型MRI系统及腕关节线圈肝脏MR扫描，包括DWI、DTI序列。扫描参数：DWI b值为0，500 s/mm2；DTI b值为500 s/mm2，在6个正交方向施加扩散梯度。层厚3 mm，矩阵192×128，激励次数(NEX)为4。在ADW 4.4工作站上分别对DWI及DTI进行后处理，重建出ADC图及FA图(DTI)。分别测量肝脏右叶的ADC值及FA值。应用秩和检验分析DWI的ADC值及DTI的ADC值、FA值与正常、肝纤维化、早期肝硬化分级的相关性，并进行两两比较。结果 DWI的ADC值在正常组(0.001545±0.00013)、肝纤维化组(0.001116±0.00014)、早期肝硬化组(0.000791±0.00018)中呈递减趋势，正常组与肝纤维化组、早期肝硬化组差异有统计学意义(P<0.05)，而肝纤维化组与早期肝硬化组差异无统计学意义。DTI序列中，正常组ADC值(0.017175±0.00097)×10-7高于肝纤维化组(0.011510±0.00080)×10-7和早期肝硬化组(0.010556±0.00195)×10-7，差异有统计学意义，但纤维化组与早期肝硬化组之间的差异无统计学意义；FA值在正常组(0.2278±0.0123)、肝纤维化组(0.3088±0.1509)与早期肝硬化组(0.4216±0.0388)中呈递增趋势，各组之间差异均有统计学意义(P<0.05)。结论肝脏DWI与DTI的ADC值均可用于对肝脏纤维化性病变的评估，但对区分肝纤维化与早期肝硬化的价值有限。D T I的FA值不但能区分正常与肝脏纤维化性病变，而且能较好地反映肝纤维化与早期肝硬化之间的差异。
목적：통과대서모형비교병평고상규DWI화DTI간섬유화급조기간경화적림상감별진단적개치。재료여방법채용경전사록화탄방법건립SD대서간섬유화모형7지、조기간경화모형5지，정상대조조6지(해실험경실험동물윤리위원회비준)。채용1.5 T초도형MRI계통급완관절선권간장MR소묘，포괄DWI、DTI서렬。소묘삼수：DWI b치위0，500 s/mm2；DTI b치위500 s/mm2，재6개정교방향시가확산제도。층후3 mm，구진192×128，격려차수(NEX)위4。재ADW 4.4공작참상분별대DWI급DTI진행후처리，중건출ADC도급FA도(DTI)。분별측량간장우협적ADC치급FA치。응용질화검험분석DWI적ADC치급DTI적ADC치、FA치여정상、간섬유화、조기간경화분급적상관성，병진행량량비교。결과 DWI적ADC치재정상조(0.001545±0.00013)、간섬유화조(0.001116±0.00014)、조기간경화조(0.000791±0.00018)중정체감추세，정상조여간섬유화조、조기간경화조차이유통계학의의(P<0.05)，이간섬유화조여조기간경화조차이무통계학의의。DTI서렬중，정상조ADC치(0.017175±0.00097)×10-7고우간섬유화조(0.011510±0.00080)×10-7화조기간경화조(0.010556±0.00195)×10-7，차이유통계학의의，단섬유화조여조기간경화조지간적차이무통계학의의；FA치재정상조(0.2278±0.0123)、간섬유화조(0.3088±0.1509)여조기간경화조(0.4216±0.0388)중정체증추세，각조지간차이균유통계학의의(P<0.05)。결론간장DWI여DTI적ADC치균가용우대간장섬유화성병변적평고，단대구분간섬유화여조기간경화적개치유한。D T I적FA치불단능구분정상여간장섬유화성병변，이차능교호지반영간섬유화여조기간경화지간적차이。
Objective:To evaluate and compare the FA of DTI and the ADC of DWI in differentiating liver ifbrosis and early liver cirrhosis in a rodent model study. Materials and Methods:This study was approved by the animal Ethics Committee in our hospital. 12 rodent models, including liver ifbrosis (7 in total with 2 in grade II and 5 in grade III from pathologic exam) and cirrhosis (5 pathologically conifrmed) ones, were established though periodical carbon tetrachloride (CCl4) injection to Wistar male rats with another 6 intact as the control. The MR exams were performed on a 1.5 T scanner (GE HDx, Mikauwee) using a wrist joint coil with the protocol including the routine T1WI, T2WI and DWI and DTI. For the objectiveness of comparison the scanning parameters were set basically identical for DWI and DTI, where FOV=16 cm×12 cm with a matrix of 192×128, slice thickness=3 mm and b=0, 500 s/mm2 with on 6 orthogonal directions applied for DTI. The MR images were blindly reviewed and analyzed by two experienced observers with the values of ADC and FA of the right liver lobe measured using the Functool on GE ADW 4.4 workstation. The ADC values of DWI and DTI, and FA values of DTI were statistically analyzed using software SPSS 13.0 with P<0.05 considered statistical signiifcant. Results:A pounced trend in a decreasing manner was observed in the ADC values of both DWI and DTI from the control group to the liver ifbrosis group, then to the early cirrhosis group. However, signiifcant difference was only observed in the comparison of the control group respectively to the ifbrosis and early cirrhosis groups (P<0.05), while not between the liver ifbrosis and early cirrhosis groups. The FA values of DTI exhibited an increasing trend from the control to liver ifbrosis, then to early liver cirrhosis groups, with statistically signiifcant differences between each group observed (P<0.05). Conclusions:The FA of DTI showed a stronger capability than the ADC values of DWI and DTI in differentiating the early cirrhosis from liver ifbrosis.