CAJ | 학술논문

目的探讨动态对比增强MRI(DCE-MRI)结合Patlak模型评估多发性硬化(MS)患者病灶及看似正常白质(NAWM)区的渗透和灌注特点的价值.方法回顾性分析23例复发-缓解型多发性硬化(RRMS)患者的影像检查资料,所有患者行常规MRI和DCE-MRI检查,然后应用单室Patlak模型进行数据后处理,计算MS患者脑内非强化病灶、病灶旁NAWM区、远离病灶NAWM区的容积转移常数(Ktrans)、对比剂血管内容积(Vp)及灌注参数脑血流量(CBF)和脑血容量(CBV),以中位数(上四分位数,下四分位数)表示,采用Kruskal-Wallis H秩和检验进行统计学分析,并绘制灌注伪彩图.结果非强化病灶区、病灶旁NAWM区与远离病灶NAWM区的Ktrans值分别为0.132(0.064, 0.233)、0.111(0.060, 0.233)、0.077(0.044, 0.185) min-1,非强化病灶区的Ktrans值明显高于远离病灶的NAWM区(χ2=7.582,P<0.05),病灶旁NAWM区Ktrans值与非强化病灶区和远离病灶NAWM区Ktrans差异均无统计学意义(P值均>0.05).非强化病灶区、病灶旁NAWM区与远离病灶NAWM区的CBV值分别为10.660(5.555, 22.193)、9.359(4.883, 16.290)、6.814(4.699, 13.623) ml·100 g-1,非强化病灶CBV明显高于远离病灶NAWM区,差异有统计学意义(χ2=6.394,P<0.05);病灶旁NAWM区与非强化病灶及远离病灶旁NAWM区的CBV差异均无统计学意义(P值均>0.05).3个部位间Vp和CBF差异均无统计学意义(P值均>0.05).结论基于T1WI的DCE-MRI结合Patlak模型能定量分析MS患者病灶及NAWM区的灌注及渗透特点,准确地反映MS的血流动力学改变.
목적 탐토동태대비증강MRI(DCE-MRI)결합Patlak모형평고다발성경화(MS)환자병조급간사정상백질(NAWM)구적삼투화관주특점적개치.방법 회고성분석23례복발-완해형다발성경화(RRMS)환자적영상검사자료,소유환자행상규MRI화DCE-MRI검사,연후응용단실Patlak모형진행수거후처리,계산MS환자뇌내비강화병조、병조방NAWM구、원리병조NAWM구적용적전이상수(Ktrans)、대비제혈관내용적(Vp)급관주삼수뇌혈류량(CBF)화뇌혈용량(CBV),이중위수(상사분위수,하사분위수)표시,채용Kruskal-Wallis H질화검험진행통계학분석,병회제관주위채도.결과 비강화병조구、병조방NAWM구여원리병조NAWM구적Ktrans치분별위0.132(0.064, 0.233)、0.111(0.060, 0.233)、0.077(0.044, 0.185) min-1,비강화병조구적Ktrans치명현고우원리병조적NAWM구(χ2=7.582,P<0.05),병조방NAWM구Ktrans치여비강화병조구화원리병조NAWM구Ktrans차이균무통계학의의(P치균>0.05).비강화병조구、병조방NAWM구여원리병조NAWM구적CBV치분별위10.660(5.555, 22.193)、9.359(4.883, 16.290)、6.814(4.699, 13.623) ml·100 g-1,비강화병조CBV명현고우원리병조NAWM구,차이유통계학의의(χ2=6.394,P<0.05);병조방NAWM구여비강화병조급원리병조방NAWM구적CBV차이균무통계학의의(P치균>0.05).3개부위간Vp화CBF차이균무통계학의의(P치균>0.05).결론 기우T1WI적DCE-MRI결합Patlak모형능정량분석MS환자병조급NAWM구적관주급삼투특점,준학지반영MS적혈류동역학개변.
Objective To evaluate dynamic contrast-enhanced MRI (DCE-MRI) with Patlak model for depicting the perfusion and permeability characteristics of lesions and normal-appearing white matter (NAWM) regions in patients with relapsing-remitting multiple sclerosis (RRMS). Methods Twenty-three patients with clinical confirmed RRMS were retrospectively analyzed, who had underwent conventional MRI and DCE-MRI using a 3.0 T MR scanner . The clinical characteristics and imaging data were collected. Post-processing was performed using the Patlak model. Volume transfer constant (Ktrans), fractional plasma volume (Vp) and perfusion parameters including cerebral blood flow (CBF) and cerebral blood volume (CBV) were represented as median and interquartile range(IQR). The four parameters of non-enhanced(NE) lesions, NAWM regions located close to NE lesions(NAWM close) and NAWM regions located far from NE lesions (NAWM far) were compared using the Kruskal-Wallis H rank sum test. Artificial color mappings were also proceeded. Results MR imaging biomarkers Ktrans was 0.132(0.064, 0.233) min-1 for NE lesions, 0.111 (0.060, 0.233) min-1 for NAWM close and 0.077(0.044, 0.185) min-1 for NAWM far, respectively. CBV was 10.660(5.555, 22.193) ml · 100 g-1 for NE lesions, 9.359(4.883, 16.290) ml · 100 g-1 for NAWM close, 6.814 (4.699, 13.623) ml·100 g-1 for NAWM far, respectively. Ktrans and CBV of NE lesions was significantly higher than that of NAWM far(χ2=7.582,P<0.05;χ2=6.394,P<0.05, respectively). Ktrans and CBV of NAWM close showed no significant differences compared with NE lesions and NAWM far. Vp and CBF had no significant differences between NE lesions, NAWM close and NAWM far regions(P>0.05). Conclusion DCE-MRI with Patlak model can measure perfusion and permeability characteristics and hemodynamic abnormalities of NE lesions and NAWM regions in patients with multiple sclerosis.