| 李洁,张晨,郑卓肇.Gd-BOPTA增强MRI评价肝功能储备[J].中国医学影像技术,2017,33(4):545~549 |
| Gd-BOPTA增强MRI评价肝功能储备 |
| Gd-BOPTA enhanced MRI in evaluation of reserved liver function |
| 投稿时间：2016-09-14 修订日期：2016-12-05 |
| DOI：10.13929/j.1003-3289.201609061 |
| 中文关键词: 磁共振成像 肝功能 钆贝葡胺 |
| 英文关键词:Magnetic resonance imaging Liver function Gadobenate dimeglumine |
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| 中文摘要: |
| 目的 探索钆贝葡胺（Gd-BOPTA）增强MRI评价肝功能储备的价值。方法 选择于我院接受Gd-BOPTA增强MR检查的患者143例，其中纳入68例。测量快速三维扰相梯度回波序列（LAVA-Flex）肝胆期肝实质各叶和全肝SNR强化率和CNR强化率。依据Child-Turcotte-Pugh（CTP）分级分为A级和B级，依据integrated MELD（iMELD）评分分为iMELD≤30和>30。比较组间SNR强化率与CNR强化率差异、分析强化率与肝功能评分之间的关系。结果 肝脏各叶及全肝SNR强化率、CNR强化率差异均无统计学意义（P均>0.05）。CTP分级A级患者全肝SNR和CNR强化率显著高于B级患者（P<0.05）。iMELD≤30患者全肝SNR和CNR强化率显著高于>30患者（P<0.05）。SNR强化率、CNR强化率与iMELD分值均呈负相关（r=-0.29、-0.32，P=0.02、0.01）。结论 肝细胞对Gd-BOPTA摄取量随着肝功能损害程度增加而下降，通过测量Gd-BOPTA增强MRI肝胆期分叶或全肝实质强化率，可以在一定程度上反映肝功能储备情况。 |
| 英文摘要: |
| Objective To investigate the value of gadobenate dimeglumine (Gd-BOPTA) enhanced MRI in evaluation of reserved liver function. Methods Totally 68 patients were included among 143 patients who underwent Gd-BOPTA enhanced MRI. The enhancement ratios of SNR and CNR of right lobe, left lobe and caudal lobe were calculated on the images from liver acquisition with volume acceleration flex sequence (LAVA-Flex) of hepatobiliary phase. The average values of right and left lobes and of three lobes were calculated and compared. According to Child-Turcotte-Pugh (CTP) classification, the patients were divided into Class A and Class B. Integrated model of end-stage liver disease (iMELD) was applied to divide the patients into iMELD ≤ 30 and iMELD > 30. The differences of SNR and CNR enhanced ratios were compared, and the relationship between enhancement ratios and iMELD scores was analyzed. Results There were no significant differences in the enhancement ratios of SNR and CNR among each lobe, the average of two or three lobes (all P>0.05). The SNR and CNR enhancement ratios of Class A were higher than those of Class B (both P<0.05). The SNR and CNR enhancement ratios of iMELD ≤ 30 were higher than those of iMELD>30 (both P<0.05). The SNR and CNR enhancement ratios showed negative correlations with iMELD scores (SNR:r=-0.29, P=0.02; CNR:r=-0.32, P=0.01). Conclusion The intracellular uptake of Gd-BOPTA decreases with impaired liver function. Measurement of the degree of parenchymal enhancement of any lobe or the whole liver on the images of Gd-BOPTA-enhancement MRI in the hepatobiliary phase might reflect the reserved liver function. |
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