| 陈晓丹,张宇阳,熊美连,林娜,曹代荣.钆贝葡胺肝胆期肝功能评估的临床价值[J].中国医学影像技术,2020,36(1): |
| 钆贝葡胺肝胆期肝功能评估的临床价值 |
| The value of Gd-BOPTA-enhanced magnetic resonance imaging in assessing liver function |
| 投稿时间：2019-04-17 修订日期：2020-01-05 |
| DOI： |
| 中文关键词: 钆贝葡胺，肝胆期，肝功能，相对强化程度，预测因素。 |
| 英文关键词:Gd-BOPTA Hepatocyte-phase Liver function Relative enhancement Predictive factors. |
| 基金项目:无 |
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| 中文摘要: |
| 目的：使用钆贝葡胺（Gadobenate-dimeglumine，Gd-BOPTA）探讨肝胆期肝实质相对强化程度与肝功能指标之间的相关性。
方法：回顾性纳入2018年1月至2019年1月在本院行Gd-BOPTA增强MRI检查的患者238例，分为四组：肝功能正常、肝硬化Child-Pugh分级A级、B级、C级组。测量肝胆期肝实质相对强化程度（relative enhancement，RE），采用统计学方法分析影响肝胆期肝实质RE的独立预测因素。
结果：Gd-BOPTA增强MRI肝胆期肝实质RE增加与总胆红素、凝血酶原时间、国际标准化比率、谷丙转氨酶、谷草转氨酶、碱性磷酸酶及肝硬化Child-Pugh分级减少有相关性(p<0.01），肝胆期肝实质RE增加与血清白蛋白、胆碱酯酶升高有相关性（（p<0.01）。腹水病人肝胆期肝实质RE低于无腹水组（p<0.001）。肝功能正常组肝胆期肝实质RE高于肝硬化Child-Pugh分级A、B、C组（p<0.001），肝硬化Child-Pugh分级A组肝胆期肝实质RE高于B、C组（p<0.001）。总胆红素、白蛋白、腹水及碱性磷酸酶是Gd-BOPTA增强MRI肝胆期肝实质RE的独立预测因素。
结论：Gd-BOPTA增强MRI肝胆期肝实质RE与肝功能指标之间有良好的相关性。总胆红素、白蛋白、腹水及碱性磷酸酶是Gd-BOPTA增强MRI肝胆期肝实质RE的独立预测因素。 |
| 英文摘要: |
| Objective:To investigate the relationships between liver function parameters and the degree of liver parenchymal enhancement on the hepatocyte phase on gadobenate dimeglumine (Gd-BOPTA)-enhanced magnetic resonance (MR) imaging, and clinical predictive factors affecting the degree of liver parenchymal enhancement.
Methods:In this study, 238 patients were classified into the following 4 groups: patients with normal liver function (the NLF group) and cirrhosis patients with Child–Pugh Classes A, B, and C (the LCA, LCB, and LCC groups, respectively). The relative enhancement ratio (RE) of the liver parenchyma in the T1-vibe sequence was calculated from measurements of the signal intensity before and 90 min after the intravenous administration of Gd-BOPTA. Statistical analysis was used to evaluate the relationship between the RE of the liver parenchyma and liver function parameters and clinical predictive factors affecting the degree of liver parenchymal enhancement on the hepatocyte phase on Gd-BOPTA-enhanced MR imaging, as well as the different RE of the liver parenchyma among the NLF, LCA, LCB, LCC groups.
Results:Increased RE of the hepatic parenchyma showed correlations with decreased serum levels of total bilirubin, prothrombin time, international normalized ratio, alanine aminotransferase, aspartate aminotransferase, alkaline phosphatase, Child-Pugh scorces(p<0.01) and elevated albumin, cholinesterase(p<0.01)for all of the patients. The RE of the liver parenchyma were significantly higher for the NLF groups compared with the LCA,LCB and LCC (p<0.001) groups, respectively. The RE of the liver parenchyma were significantly higher for the LCA groups compared with the LCB and LCC groups, respectively. No significant differences were observed between the LCB and LCC groups (P=0.09), with regard to the RE of the liver parenchyma. A multiple stepwise regression analysis revealed that total bilirubin, albumin, alkaline phosphatase, and the presence of ascites were the only factors that predicted liver parenchymal enhancement on hepatocyte phase images.
Conclusion:This study demonstrates that there was a significantly correlations between the RE of the liver parenchyma and liver functional parameters and the total bilirubin, albumin, ALP, and the presence of ascites were the only factors that predicted liver parenchymal enhancement on hepatocyte phase images. |
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