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肝切除术后患者门静脉和肝静脉磁共振成像血流测量的临床评估

Clinical evaluation of magnetic resonance imaging flowmetry of portal and hepatic veins in patients following hepatectomy.

作者信息

Nanashima A, Shibasaki S, Sakamoto I, Sueyoshi E, Sumida Y, Abo T, Nagasaki T, Sawai T, Yasutake T, Nagayasu T

机构信息

Division of Surgical Oncology, Department of Translational Medical Sciences, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan.

出版信息

Liver Int. 2006 Jun;26(5):587-94. doi: 10.1111/j.1478-3231.2006.01273.x.

Abstract

BACKGROUND

Hepatic blood flow was associated with degree of hepatic damage. Measurements of blood flow using ultrasonography (US) may vary due to any observer's and patient's conditions. The utility of magnetic resonance imaging (MRI) flowmetry in portal and hepatic veins was assessed.

PATIENTS AND METHODS

Using the phase-contrast method, the mean flow velocity of portal (PVF) and hepatic vein (HVF) were determined by MRI and US in 75 consecutive patients with liver diseases, including 58 patients undergoing hepatectomy. The correlations between these parameters and clinicopathological findings were examined.

RESULTS

PVF and HVF measured by MRI flowmetry were 12.8+/-4.5 and 14.7+/-5.3 cm/s, respectively. There was no significant correlation of both flows between MRI and US. PVF correlated significantly with portal pressure (r = -0.722; P < 0.05). There was a negative correlation between HVF and histological activity index score (r = -0.366; P < 0.05). PVF and HVF were lower in patients with cirrhosis and higher staging score (2-4) and PVF was lower in patients with higher grading score (2-3; P < 0.05). PVF and HVF were not significantly associated with postoperative complications.

CONCLUSIONS

Our results suggest that MRI flowmetry is a potentially useful tool for measurement of hepatic blood flow and recommend its use for estimation of liver cirrhosis-associated impairment.

摘要

背景

肝血流与肝损伤程度相关。使用超声检查(US)测量血流可能因观察者和患者的任何情况而有所不同。评估了磁共振成像(MRI)血流测量在门静脉和肝静脉中的效用。

患者和方法

采用相位对比法,对75例连续的肝病患者,包括58例接受肝切除术的患者,通过MRI和US测定门静脉平均流速(PVF)和肝静脉平均流速(HVF)。检查了这些参数与临床病理结果之间的相关性。

结果

MRI血流测量法测得的PVF和HVF分别为12.8±4.5和14.7±5.3cm/s。MRI和US测得的两种血流之间无显著相关性。PVF与门静脉压力显著相关(r = -0.722;P < 0.05)。HVF与组织学活动指数评分呈负相关(r = -0.366;P < 0.05)。肝硬化患者及分期评分较高(2 - 4)者的PVF和HVF较低,分级评分较高(2 - 3)者的PVF较低(P < 0.05)。PVF和HVF与术后并发症无显著相关性。

结论

我们的结果表明,MRI血流测量是一种潜在有用的肝血流测量工具,并建议将其用于评估肝硬化相关损伤。

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