Gd-EOB-DTPA增强MRI与肝脏体积评估肝储备功能的应用价值  

The application value of liver volume measurement and Gd-EOB-DTPA enhanced MRI to evaluate hepatic reserve function

作　　者：李迅 杨新官[1] 蒋宇 邱维加[1] LI Xun;YANG Xinguan;JIANG Yu;QIU Weijia(Department of Radiology ,the Affiliated Hospital of Guilin Medical University ,Guilin 541001 ,China)

机构地区：[1]桂林医学院附属医院放射科,广西桂林541001

出　　处：《实用放射学杂志》2018年第4期545-548,共4页Journal of Practical Radiology

基　　金：桂林市科学研究与技术开发计划项目（20170109-8）.

摘　　要：目的 探讨肝脏体积（LV）与钆塞酸二钠（Gd-EOB-DTPA）增强MRI相关指标在肝储备功能评估应用中的价值，并尝试结合二者得到更优的肝储备功能评价方法。方法 本研究回顾性分析42例肝脏局灶性病变患者的临床及影像资料。所有患者均完成Gd-EOB-DTPA增强MRI扫描、Child-Pugh评分和吲哚菁绿（ICG）清除试验，使用肝脏相对强化程度（RE）、LV评估肝储备功能。使用独立样本t检验比较Child-Pugh A级与Child-Pugh B级2组LV、LV/标准肝脏体积（SLV）、RE的差异，Spearman相关分析ICG 15 min滞留率（ICG-R15）与LV、LV/SLV、RE、RE×LV、RE×LV/SLV等的相关性。结果 Child-Pugh 2组间LV差异无显著性（P〉0.05），2组间 RE差异有统计学意义（P=0.039）；ICG-R15与LV、LV/SLV无显著性相关（P〉0.05），ICG-R15与RE、RE×LV、RE×LV/SLV显著负相关，RE×LV/SLV与ICG-R15相关性最强（r=-0.524，P=0.000）。结论 Gd-EOB-DTPA 增强MRI可用于评估肝储备功能状态，RE结合LV指标是评估肝储备功能更有效的方法。Objective To probe the value of both liver volume（LV） measurement and Gd-EOB-DTPA enhanced MRI to evaluate hepatic reserve function in order to obtain a better assessment method.Methods Clinical and imaging data of 42 patients with hepatic focal lesions were analyzed retrospectively.Gd-EOB-DTPA enhanced MRI scan,Child-Pugh scoring and ICG- clearance tests were performed in all patients,and the liver relative enhancement （RE） and LV were used to assess the hepatic reserve function.The differences of LV, LV/standard liver volume （SLV） and RE between the Child-Pugh class A and B were compared using independent student＇s t-test. Spearman correlation analysis was applied to analyze the relationship of indocyanine green retention rate at 15 minutes （ICG-R15） with the LV,LV/SLV,RE,REXLV and REX LV/SLV.Results There was no significant difference in LV between two groups（P〉0.05）, whereas the RE had significant difference（P =0.039）.There were no significant correlations between ICG-R15 and LV, LV/SLV（P〉0.05）. ICG-R15 was negatively correlated with RE, REX LV and REX LV/SLV, and REX LV/SLV showed significant correlation with ICG-R15 （r=--0.524,P=0.000）. Conclusion Gd-EOB-DTPA enhanced MRI can assess the status of hepatic reserve function, while the combination of RE with LV is a more effective method.

关 键 词：磁共振成像 钆塞酸二钠 肝脏体积测量 肝储备功能 

分 类 号：R445.2[医药卫生—影像医学与核医学] R322.47[医药卫生—诊断学]