| 刘茂童,陆健,张学琴,张涛,姜吉锋,丁丁,杜圣.基于钆塞酸二钠增强MRI肝细胞分数评估肝脏储备功能[J].中国医学影像技术,2020,36(10):1490~1494 |
| 基于钆塞酸二钠增强MRI肝细胞分数评估肝脏储备功能 |
| Evaluation of liver function with hepatocyte fraction based on Gd-EOB-DTPA-enhanced liver MRI |
| 投稿时间：2019-09-26 修订日期：2020-04-21 |
| DOI：10.13929/j.issn.1003-3289.2020.10.012 |
| 中文关键词: 肝功能 造影剂 磁共振成像 |
| 英文关键词:liver function contrast media magnetic resonance imaging |
| 基金项目:南通市科技计划项目（MSZ18261）。 |
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| 中文摘要: |
| 目的 探讨基于钆塞酸二钠（Gd-EOB-DTPA）肝脏增强MRI肝细胞分数（HeF）评估肝脏储备功能的价值。方法 按照终末期肝病模型（MELD）评分将82例接受上腹部MRI的有慢性乙型病毒性肝炎病史或疑诊肝脏局灶性病变患者分为MELD ≤ 10分组（n=61）和MELD>10分组（n=21）。于注射Gd-EOB-DTPA增强前后20 min行T1 mapping成像，获取HeF、K值、平扫肝脏T1（T1pre）、增强后20 min肝脏T1（T1post）、T1弛豫率增加值（ΔR1）和T1弛豫时间减低率（ΔT1）。比较组间上述各参数差异；采用多因素Logistic回归分析观察组间差异有统计学意义的参数，评价对MELD>10分的重要预测因素，分析各参数与MELD评分的相关性；采用ROC曲线评价各参数对不同肝功能患者的诊断效能。结果 除T1pre外，2组间各参数差异均有统计学意义（P均<0.05）。回归分析显示K值是MELD评分>10分的重要预测因素（P=0.01）。T1pre及T1post均与MELD评分呈正相关（r=0.46、0.73，P均<0.01），ΔT1、ΔR1、HeF及K值均与MELD评分呈负相关（r=-0.60、-0.52、-0.73和-0.49，P均<0.01）。HeF、K值、T1post、ΔT1及ΔR1鉴别不同肝功能患者的AUC分别为0.77、0.84、0.75、0.75及0.77（P均=0.01）。结论 Gd-EOB-DTPA肝脏增强MRI的HeF及其他参数可用于评价肝脏储备功能。 |
| 英文摘要: |
| Objective To explore the value of hepatocyte fraction (HeF) based on gadolinium ethoxybenzyl diethylenetriaminepentaacetic acid (Gd-EOB-DTPA) enhanced liver MRI for evaluating liver function. Methods A total of 82 patients with a history of chronic vira hepatitis B or suspected focal liver lesions underwent upper abdominal MRI were collected. The patients were divided into model for end-stage liver disease (MELD) ≤ 10 group (n=61) and MELD>10 group (n=21) according to the MELD score of end-stage liver disease model. T1 mapping imaging was collected before and 20 minutes after Gd-EOB-DTPA administration, and parameters including precontrast and postcontrast T1 values of the liver (T1pre and T1post), the increase of T1 relaxation rate (ΔR1), the decrease rate of T1 relaxation time (ΔT1), HeF and K value were obtained and compared between 2 groups. For the parameters being statistically different between groups, multivariate Logistic regression was used to analyze the important predictors of liver function MELD>10. The correlations between each parameter and MELD score were analyzed, and the diagnostic efficacy of each parameter in differential diagnosis of patients with different liver function was evaluated by using ROC curve. Results There were significant differences of all parameters but T1pre between 2 groups (all P<0.05). Regression analysis showed that K value was important predictive factor of MELD score >10 (P=0.01). Both T1pre and T1post were positively correlated with MELD score (r=0.46, 0.73, both P<0.01), while ΔT1, ΔR1, HeF and K value were negatively correlated with MELD score (r=-0.60, -0.52, -0.73, -0.49, all P<0.01). AUC of HeF, K value, T1post, ΔT1 and ΔR1 for identifying patients with different liver function was 0.77, 0.84, 0.75, 0.75 and 0.77 (all P=0.01), respectively. Conclusion HeF and other parameters based on Gd-EOB-DTPA enhanced liver MRI could be used to evaluate liver function. |
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