肝细胞特异性MR对比剂在肝脏功能评价中的初步研究  

Preliminary study of hepatocyte-specific MR contrast agent in the evaluation of liver function

作　　者：罗宴吉[1] 蔡华崧[1] 汤地[2] 伍玲[1] 彭振鹏[1] 李子平[1] 郑可国[1] 殷晓煜[2] 冯仕庭[1] 

机构地区：[1]中山大学附属第一医院放射科,广州510080 [2]中山大学附属第一医院肝胆外科,广州510080

出　　处：《中华消化病与影像杂志（电子版）》2013年第5期23-26,共4页Chinese Journal of Digestion and Medical Imageology(Electronic Edition)

基　　金：国家自然科学基金青年基金(81000626);中央高校基本科研业务费专项资金(10ykpy11);广东省自然科学基金(S2011010004826);广东省科技计划项目(2010B031600080)

摘　　要：目的分析不同功能级别肝功能患者注射肝细胞特异性对比剂钆塞酸二钠(Gd-EOBDTPA)后肝脏信号强度的变化规律,探讨Gd-EOB-DTPA在肝功能评价中的应用。方法 28例患者使用Gd-EOB-DTPA作为对比剂行肝脏MR增强扫描,均按照Child-Pugh分级法行肝脏功能分级,其中Child-Pugh A级15例,B级9例,C级4例。每例分别于轴位片上同一层面的肝脏及竖脊肌各确定一感兴趣区域,测量感兴趣区域对比增强前反相位信号强度(S1、S2)及注射对比剂后肝细胞期(静脉注射20 min后)的信号强度(S3、S4),分别计算两个时期肝脏与竖脊肌信号强度的比值(Ratio1=S1/S2,Ratio2=S3/S4)。再用Ratio1及Ratio2计算信号比增加百分率[Increased Signal%=(Ratio2-Ratio1)/Ratio2×100%]表示肝脏增强程度。统计分析不同功能级别肝脏IS%的差异是否具有统计学意义。结果 Child-Pugh肝功能A级的IS%较B级和C级的高,A级与B级(P=0.000)、A级与C级(P=0.000)之间IS%的差异有统计学意义。Child-Pugh肝功能B级与C级之间IS%的差异无统计学意义(P=0.318)。结论 Gd-EOB-DTPA MR增强扫描可在一定程度上反应肝脏细胞功能,可作为肝脏功能评价的一种新方法。Objective To analyze the signal intensity changes of different liver function patients after the injection with hepatocyte-specific contrast agent gadolinium ethoxybenzyl diethylene-triamine pentaacetic acid （Gd-EOB-DTPA）, and to explore the application of Gd-EOB-DTPA in liver function evaluation. Methods 28 patients underwent Gd-EOB-DTPA-enhanced MRI. All cases were classified as Child-Pugh class A in 15 patients, Child-Pugh class B in 9 patients, and Child-Pugh class C in 4 patients. We chose region of interest （ROI） of each patients at the same level of liver and paraspinal muscle on axial image, measured the signal intensity of ROI of anti-phase before （ S1, $2） and after （ $3, $4 ） contrast agent injection,and calculated Ratio 1 and Ratio 2 （Ratiol = S1/$2, Ratio2 = $3/$4 ）, then calculated IS% （ Increased Signal% = （ Ratio2-Ratiol ）/ Ratio2 x 100% ） to show hepatic enhancement degree. Finally, the difference of IS% between the two groups was analyzed. Results IS% of liver function with Child-Pugh Class A was higher than B and C, and the differences between Child-Pugh Class A and B （ P = O. 000）, between Child-Pugh Class A and C （ P = 0. 000） were statistically significant, but the difference between Child-Pugh Class B and C was not statistically significant （ P = 0. 318 ）. Conclusions Gd-EOB-DTPA- enhanced MRI can reflect the hepatocyte function to some extent,which can be used as a new method in liver function evaluation.

关 键 词：造影剂 敏感性与特异性 磁共振成像 CHILD-PUGH肝功能分级 钆塞酸二钠 

分 类 号：R445.2[医药卫生—影像医学与核医学]