中国肝脏病杂志（电子版）
中國肝髒病雜誌（電子版）
중국간장병잡지（전자판）
Chinese Journal of Liver Diseases (Electronic Version)
2015年
3期
120-126
,共7页
李俊林%王丽娜%张雪峰%孙磊
李俊林%王麗娜%張雪峰%孫磊
리준림%왕려나%장설봉%손뢰
PROPELLER MRI%肝癌形成%肝结节%DEN
PROPELLER MRI%肝癌形成%肝結節%DEN
PROPELLER MRI%간암형성%간결절%DEN
PROPELLER MRI%Hepatocarcinogenesis%Hepatic nodules%DEN
目的：通过大鼠肝癌模型的建立，评价MRI（magnetic resonance imaging）在肝癌的发生发展过程中的影像学诊断价值，为肝癌的早期诊断提供依据。方法32只大鼠饮用DEN（diethylnitrosamine）后成功建立大鼠肝癌模型，在肝硬化基础上出现的肝细胞结节包括再生结节（regenerative nodule， RN）、不典型腺瘤样增生结节（dysplastic nodule，DN）、肝细胞癌（hepatocellular carcinoma， HCC）、囊肿和血管瘤，经过PROPELLER（periodically rotated overlapping parallel lines with enhanced reconstruction） MRI（弥散加权，T2、T1加权及部分增强）扫描，测量每个肿瘤的表面弥散系数（apparent diffusion coefficient，ADC）值和T2值。每个类型的肝细胞结节测量ADC和T2值，最后经组织病理学证实影像学诊断。结果 PROPELLER图像和结合参数图像是内在的相互配准，无明显的图像失真或运动伪影。在常规的T1和T2加权图像上肝细胞结节的所有类型显示了复杂的影像特征。囊肿ADC和T2值分别是（4.04±0.28）×10-3 mm2/s、（1459.8±312.9）×10-3 s，显著高于RN、DN、HCC的ADC和T2值，差异具有统计学意义（6组P均＜0.001）；血管瘤ADC和T2值分别是（3.57±0.44）×10-3 mm2/s、（1377.9±228.5）×10-3 s，也显著高于RN、DN、HCC的ADC和T2值，差异具有统计学意义（6组P均＜0.001）；然而在HCC、DN和RN之间，ADC和T2值无显著性差异；在囊肿和血管瘤之间，ADC和T2值无显著性差异。结论 DEN能够成功诱发大鼠从肝硬化到RN、DN及HCC的多阶段病变过程；多次激发PROPELLER MRI对于定量腹部肿瘤学影像是一种可行的方法；使用PROPELLER MRI技术，定量的ADC和T2测量能够提供固有的互相配准多参数图，图像无扭曲或明显的运动伪影；利用PROPELLER MRI技术在肝癌的早期诊断、疗效评价及预后评估方面提供了理论依据。
目的：通過大鼠肝癌模型的建立，評價MRI（magnetic resonance imaging）在肝癌的髮生髮展過程中的影像學診斷價值，為肝癌的早期診斷提供依據。方法32隻大鼠飲用DEN（diethylnitrosamine）後成功建立大鼠肝癌模型，在肝硬化基礎上齣現的肝細胞結節包括再生結節（regenerative nodule， RN）、不典型腺瘤樣增生結節（dysplastic nodule，DN）、肝細胞癌（hepatocellular carcinoma， HCC）、囊腫和血管瘤，經過PROPELLER（periodically rotated overlapping parallel lines with enhanced reconstruction） MRI（瀰散加權，T2、T1加權及部分增彊）掃描，測量每箇腫瘤的錶麵瀰散繫數（apparent diffusion coefficient，ADC）值和T2值。每箇類型的肝細胞結節測量ADC和T2值，最後經組織病理學證實影像學診斷。結果 PROPELLER圖像和結閤參數圖像是內在的相互配準，無明顯的圖像失真或運動偽影。在常規的T1和T2加權圖像上肝細胞結節的所有類型顯示瞭複雜的影像特徵。囊腫ADC和T2值分彆是（4.04±0.28）×10-3 mm2/s、（1459.8±312.9）×10-3 s，顯著高于RN、DN、HCC的ADC和T2值，差異具有統計學意義（6組P均＜0.001）；血管瘤ADC和T2值分彆是（3.57±0.44）×10-3 mm2/s、（1377.9±228.5）×10-3 s，也顯著高于RN、DN、HCC的ADC和T2值，差異具有統計學意義（6組P均＜0.001）；然而在HCC、DN和RN之間，ADC和T2值無顯著性差異；在囊腫和血管瘤之間，ADC和T2值無顯著性差異。結論 DEN能夠成功誘髮大鼠從肝硬化到RN、DN及HCC的多階段病變過程；多次激髮PROPELLER MRI對于定量腹部腫瘤學影像是一種可行的方法；使用PROPELLER MRI技術，定量的ADC和T2測量能夠提供固有的互相配準多參數圖，圖像無扭麯或明顯的運動偽影；利用PROPELLER MRI技術在肝癌的早期診斷、療效評價及預後評估方麵提供瞭理論依據。
목적：통과대서간암모형적건립，평개MRI（magnetic resonance imaging）재간암적발생발전과정중적영상학진단개치，위간암적조기진단제공의거。방법32지대서음용DEN（diethylnitrosamine）후성공건립대서간암모형，재간경화기출상출현적간세포결절포괄재생결절（regenerative nodule， RN）、불전형선류양증생결절（dysplastic nodule，DN）、간세포암（hepatocellular carcinoma， HCC）、낭종화혈관류，경과PROPELLER（periodically rotated overlapping parallel lines with enhanced reconstruction） MRI（미산가권，T2、T1가권급부분증강）소묘，측량매개종류적표면미산계수（apparent diffusion coefficient，ADC）치화T2치。매개류형적간세포결절측량ADC화T2치，최후경조직병이학증실영상학진단。결과 PROPELLER도상화결합삼수도상시내재적상호배준，무명현적도상실진혹운동위영。재상규적T1화T2가권도상상간세포결절적소유류형현시료복잡적영상특정。낭종ADC화T2치분별시（4.04±0.28）×10-3 mm2/s、（1459.8±312.9）×10-3 s，현저고우RN、DN、HCC적ADC화T2치，차이구유통계학의의（6조P균＜0.001）；혈관류ADC화T2치분별시（3.57±0.44）×10-3 mm2/s、（1377.9±228.5）×10-3 s，야현저고우RN、DN、HCC적ADC화T2치，차이구유통계학의의（6조P균＜0.001）；연이재HCC、DN화RN지간，ADC화T2치무현저성차이；재낭종화혈관류지간，ADC화T2치무현저성차이。결론 DEN능구성공유발대서종간경화도RN、DN급HCC적다계단병변과정；다차격발PROPELLER MRI대우정량복부종류학영상시일충가행적방법；사용PROPELLER MRI기술，정량적ADC화T2측량능구제공고유적호상배준다삼수도，도상무뉴곡혹명현적운동위영；이용PROPELLER MRI기술재간암적조기진단、료효평개급예후평고방면제공료이론의거。
Objective To evaluate the imaging diagnosis value of magnetic resonance imaging in hepatocarcinogenesis to provide evidences for early stage of hepatocellular carcinoma diagnosis . Methods A liver tumor model of hepatocarcinogenesis model of rats were established after 32 rats drunk with diethylnitrosamine. Hepatic nodules on the basis of cirrhosis included regenerative nodule (RN), dysplastic nodule (DN), hepatocellular carcinoma (HCC), hamangiom and cyst, and PROPELLER (periodically rotated overlapping parallel lines with enhanced reconstruction) magnetic resonce imaging (MRI) (diffusion-weighted, T2 mapping, T1-weighted and some contrast enhances) were performed. Apparent diffusion coefficient (ADC) maps and T2 maps of each tumor were generated. ADC and T2 values for each type of hepatic nodule were measured, whose imaging diagnosises were confirmed finally by histopathology. Results PROPELLER images and resultant parametric maps were inherently mutual registration without image distortion or motion artifacts. All types of hepatic nodules displayed complex imaging characteristics within conventional T1- and T2-weighted images. The ADC and T2 value of cyst were (4.04 × 10-3 ± 0.28× 10-3 ) mm2/s, (1459.8 ± 312.9) × 10-3 s, respectively, and significantly higher than ADC and T2 value of RN, DN, and HCC(P < 0.001).The ADC and T2 value of hemangioma were (3.57 ± 0.44 ) × 10-3 mm2/s, (1377.9 ± 228.5) × 10-3 s, respectively, and significantly higher than ADC and T2 value of RN, DN, and HCC (P <0.001)too. However, there was no significant difference of ADC and T2 value between HCC, DN, and RN. Also, there was no significant difference of ADC and T2 value between cyst and hemangioma. Conclusions DEN can successfully induce cirrhosis, RN, DN, and HCC in rats, which include a multistep pathy process. Multishot PROPELLER MRI is a promising method for quantitative abdominal oncologic imaging. Using PROPELLER MRI techniques, quantitative measurements of ADC and T2 could provid inherently mutual registration parametric maps without image distortion or obvious motion artifacts. They provide the theoretical basis for early diagnosis, therapeutic evaluation, and prognosis of HCC by PROPELLER MRI techniques.
