Gd-EOB-DTPA增强MRI评估乙肝肝硬化患者肝脏储备功能  

Evaluation of liver reserve function with Gd-EOB-DTPA enhanced MRI in patients with hepatitis B cirrhosis

作　　者：张继云[1] 陆健[1] 张学琴[1] 张涛[1] 姜吉锋[1] 丁丁[1] 杜圣[1] 

机构地区：[1]南通大学附属南通第三医院影像科,江苏南通226001

出　　处：《实用放射学杂志》2017年第12期1870-1873,共4页Journal of Practical Radiology

基　　金：江苏省研究生科研创新计划资助项目（SJLX16-0568）.

摘　　要：目的 探讨钆塞酸二钠（Gd-EOB-DTPA）增强MRI对乙肝肝硬化患者肝脏储备功能的评估能力。方法 收集乙型肝炎肝硬化患者及无慢性肝病病史肝功能正常者。测量所有病例MRI平扫及注射Gd-EOB-DTPA后各时间点各肝段信号强度（SI），取平均信号强度作为全肝信号强度，计算全肝不同时相肝脏相对强化程度（RE）。采用单因素方差分析比较4组间不同时间点SI及RE，同一组患者不同时间点SI及RE的比较采用Friedman秩和检验；相关分析采用Spearman秩相关分析。采用受试者工作特征（ROC）曲线分析SI和RE鉴别肝功能正常组-Child A级患者与Child B级-C级患者的诊断效能。结果 肝功能正常者21例，乙肝肝硬化患者Child-Pugh A级、B级、C级各40、48、11例。 不同组间患者SI及RE在各时间点差异有统计学意义，同一组间患者在不同时间点SI及RE差异有统计学意义（P〈0.05）；各时间点SI及RE与肝功能分级相关性：除SI20 s（r=-0.190，P=0.038）、RE20 s（r=0.081，P=0.382）外各时间点SI及RE与肝功能分级均呈高度负相关（P〈0.01），在延迟10 min时SI10 min及RE10 min与肝功能Child-Pugh分级相关性较高；SI10 min、SI20 min、RE10 min、RE20 min对预测肝功能异常ROC曲线的曲线下面积（AUC）分别是0.839、0.707、0.779、0.547。结论 Gd-EOB-DTPA增强MRI可以评估乙肝肝硬化患者肝脏储备功能，SI及RE能在一定程度上反映肝脏储备功能，在预测肝功能正常或轻度损伤与肝功能中重度损伤方面有一定价值。Objective To evaluate the ability of Gd-EOB-DTPA enhanced MRI in the evaluation of liver reserve function in patients with hepatitis B cirrhosis.Methods Patients with hepatitis B cirrhosis and controls with normal liver function and free of chronic liver disease were collected prospectively. Signal intensity （SI） of each hepatic segments （S1-S8） were measured of all cases before injection and after bolus administration of Gd-EOB-DTPA, and the whole liver signal intensity was assessed as the average signal intensity. The whole liver relative enhancement degree （relative enhancement RE} was calculated. The one way ANOVA was used to compare SI and RE among four groups at different time and the Friedman test was used to compare SI and RE within each group at different time. The Spearman rank correlation analysis was used to do correlation analysis.ROC curve was used to analyze the efficacy of Gd-EOP-DTPA enhanced MRI in the diagnosis of liver dysfunction and was used to compare the diagnostic performance of SI and RE in discriminating normal liver function group-Child A from Child B-C.Results Patients enrolled with normal liver function, Child-Pugh A,B and C was 21, 40,48 and 11. SI and RE between different groups were statistically significant at each time （P〈0.05） ; and was statistically significant at different time within the same group. Correlation analysis of SI and RE with liver function classification at different time points showed：in addition to SI20s （r=-0.190,P = 0.038）, RF40s （r=0.081 ,P=0.382）, SI and RE at each time point were highly negatively related with liver function classification （P〈0.01）. SI10min and RE10 min were higher significantly negatively related with liver function classification.The area under the ROC curve was 0.839, 0.707, 0.779 and 0.547, respectively. Conclusion Gd-EOB-DTPA enhanced MRI can assess liver reserve function in patients with hepatitis B cirrhosis, SI and RE can reflect the degree of liver function reserve in a certain extent.It has some v

关 键 词：肝脏储备功能 对比剂 磁共振成像 

分 类 号：R322.47[医药卫生—人体解剖和组织胚胎学] R445.2[医药卫生—基础医学]