Influence of perfusion on hepatic MR diffusion measurement
Influence of perfusion on hepatic MR diffusion measurement
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DOI：
10.1002/nbm.1028
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发表时间：
2006-04-01
影响因子：
2.9
通讯作者：
Lomas, DJ
中科院分区：
文献类型：
--
作者：
Hollingsworth, KG;Lomas, DJ
经皮肝活检是目前诊断和评估肝纤维化的金标准：这是一个不舒服的手术，有感染和内出血的风险。由于肝纤维化发生时肝组织的形态和生理变化，弥散加权MRI作为肝纤维化等级的非侵入性测量可能是重要的。影响肝扩散测量的因素是复杂的，被认为包括肝灌注。本研究评估肝弥散测量是否受到肝灌注变化的影响，因为这可能是研究弥散测量与肝纤维化分级之间关系的重要变量。在10名健康志愿者禁食8小时和标准餐后1小时（增加门静脉流量和肝窦灌注），使用屏气技术在b值为750、500和200 s/mm时测量肝脏表观扩散系数（adc）(2)。在右后叶使用b = 750和500 s/mm(2)的ADC测量结果不受灌注变化的影响（P分别= 0.15和0.14），而右前叶的结果在餐后显著增加（P分别= 0.03和0.008）：这些b值的受试者间变异性很低（类似于5%）。当b值为200s/mm(2)时，门静脉灌注对右肺叶后段和前段均有显著影响（p分别=0.01和0.00001）：受试者间变异性较高（类似于25%）。最可重复的ADC测量可以在右后叶进行，并且在较高的b值（b = 500和750 s/mm）时灌注的影响最小(2)。版权所有(c) 2006约翰威利父子有限公司
Percutaneous liver biopsy is the current gold standard for the diagnosis and assessment of hepatic fibrosis: it is an uncomfortable procedure with associated risks of infection and internal bleeding. Diffusion-weighted MRI may be important as a non-invasive measure of the grade of hepatic fibrosis, owing to the morphological and physiological changes in hepatic tissues as fibrosis develops. The factors that influence hepatic diffusion measurements are complex and are thought to include hepatic perfusion. This study assesses whether hepatic diffusion measurements are influenced by hepatic perfusion changes as thiS Could be an important variable when investigating the relationship between diffusion measurements and grade of hepatic fibrosis. Hepatic apparent diffusion coefficients (ADCs) were measured in 10 healthy Volunteers after an 8-h fast and 1-h after a standard meal (which increases portal vein flow and hepatic sinusoidal perfusion) using a breath-hold technique at b-values of 750, 500 and 200 s/mm(2). ADC measurements using b = 750 and 500 s/mm(2) in the posterior right lobe were unaffected by the perfusion changes (P = 0.15 and 0.14, respectively) whereas the results from the anterior right lobe significantly increased post-prandially (P = 0.03 and 0.008, respectively): inter-subject variability was low (similar to 5%) for these b-values. Portal perfusion had a significant effect in both the posterior and anterior segments of the right lobe when using a b-value of 200s/mm(2) (p=0.01 and 0.00001 respectively): inter-subject variability Was found to be high (similar to 25%). The most reproducible measurements of the ADC can be made in the posterior right lobe and the effect of perfusion is minimised at the higher b-values (b = 500 and 750 s/mm(2)). Copyright (c) 2006 John Wiley & Sons, Ltd.