磁共振功能成像监测肝纤维化疗效的实验与临床研究

肝纤维化是肝炎发展至肝硬化的可逆性阶段，肝纤维化的早期诊断与治疗对肝硬化及肝癌的防治至关重要。临床有效的抗病毒治疗可使肝纤维化一定程度的逆转，但目前缺乏安全有效、可行性强的抗纤维化的疗效监测方法。本研究秉承上一课题成果，将HBV转基因小鼠动物实验和大样本临床病例研究相结合，综合运用MR各种功能成像方法，包括弹性成像（MRE）、磁共振波谱成像（MRS）、三维全肝灌注成像（3D-PWI）及血氧水平依赖成像（BOLD），基于肝纤维化治疗过程中纤维化程度、炎症及脂肪变性程度、灌注及代谢变化，结合相应的病毒学、血清学及病理学指标的变化，评价磁共振功能成像监测肝纤维化疗效的价值，获得相应的功能磁共振的定量指标；进一步阐明抗纤维化治疗过程中肝脏功能变化的病理生理机制。本研究将为临床抗纤维化治疗的疗效监测提供一种可行性较强、准确性较高的方案，有望替代肝纤维化疗效监测中反复的肝脏穿刺，有重要的临床应用价值。

Liver fibrosis is,the early detection and antiviral treatment of liver ?brosis has imporant clinical implications in prevention of Cirrhosis and hepatic cancer. Liver fibrosis can be reversed by an effective antiviral treatment, while there is a lack of an effective and feasible project to monitor the therapeutic effectiveness. Followed our last program, this study will combine HBV transgenic mice liver fibrosis models to clinical trials,based on the stage of fibrosis and alteration of inflammation and steatosis and perfusion and metabolism, get MR elastography imaging and MR spectroscopy and whole liver perfusion imagings(PWI) and blood oxygen level dependent MR imagings (BOLD-MRI)of liver and virological examinations and fibrosis related serum indexes and pathological outcomes ,and then evaluate the value of functional MR for monitoring the therapeutic effectiveness, acquired these quantitative indexes of each stage of fibrosis,further elucidating the mechanisms of the functional alterations of liver while antiviral treatment.This study will provide an more feasible and more accurate project for monitoring the therapeutic effectiveness of treatment,and would substitute repeated liver biopsy, with a great value to clinic.