钆塞酸二钠增强T1 mapping结合肝细胞增强分数评估肝脏储备功能的价值  

Efficacy of a combination of Gd-EOB-DTPA enhanced T1 mapping and hepatocyte enhancement fraction for estimation of hepatic functional reserve

作　　者：孟迪 张宏江[2] 吴昆华[2] 胡达 柏夏薇 杨子浩 MENG Di;ZHANG Hongjiang;WU Kunhua;HU Da;BAI Xiawei;YANG Zihao(Clinical Medical College of Dali University,Dali,Yunnan Province 671000,China;MR Room,the First People’s Hospital of Yunnan,Kunming 650032,China;Clinical Medical College of Kunming University of Science and Technology,Kunming 650051,China)

机构地区：[1]大理大学临床医学院,云南大理671000 [2]云南省第一人民医院磁共振科,云南昆明650032 [3]昆明理工大学临床医学院,云南昆明650051

出　　处：《实用放射学杂志》2021年第7期1122-1126,共5页Journal of Practical Radiology

摘　　要：目的 探讨钆塞酸二钠(Gd-EOB-DTPA)增强T_(1) mapping结合肝细胞增强分数(HEF)对肝脏储备功能的评估能力.方法 回顾性纳入1周内完成了Gd-EOB-DTPA增强MRI及吲哚菁绿(ICG)滞留实验的患者104例,根据ICG 15 min清除率(ICG R_(1)5)将患者分为2组,其中ICG R_(1)5<30%患者86例,ICG R_(1)5≥30%患者18例.使用改进的Look-Locker反转恢复(MOLLI)序列分别在增强前及增强后10 min、20 min采集T_(1) mapping图像,选取4个感兴趣区(ROI)分别测量各时间点T_(1)弛豫时间,并计算T_(1)弛豫时间减低率(ΔT_(1))、T_(1)弛豫速率(ΔR_(1))、HEF以及HEF摄取系数(K).采用独立样本t检验比较ICG R_(1)5<30%组与ICG R_(1)5≥30%组T_(1)弛豫时间、ΔT_(1)、ΔR_(1)、K以及HEF.采用受试者工作特征(ROC)曲线比较不同时间点T_(1)弛豫时间、ΔT_(1)、ΔR_(1)、HEF以及K的诊断效能.结果 随着肝功能损害程度的增加,T_(1)弛豫时间延长(t=-4.751、-6.568、-7.402),而ΔT_(1)、ΔR_(1)、K和HEF值降低(t=7.901、8.846、7.905、8.991、9.074、10.931、8.193、10.063),各组间差异均有统计学意义(P<0.01).增强后20 min T_(1)弛豫时间、ΔT_(1)、ΔR_(1)、K和HEF曲线下面积(AUC)(0.935、0.926、0.93、0.944、0.944)高于增强后10 min(0.911、0.896、0.91、0.912、0.912),以增强后20 min HEF诊断性最好,各AUC差异均有统计学意义(P<0.01).结论 Gd-EOB-DTPA增强T_(1) mapping成像是评价肝脏储备功能的有效方法,结合HEF可使诊断效能进一步提高.Objective To access the ability of the ethoxybenzyl diethylenetriamine pentaacetic acid(Gd-EOB-DTPA)enhanced T_(1) mapping in combineation with hepatocyte enhancement fraction(HEF)in hepatic functional reserve.Methods A total of 104 patients who underwent Gd-EOB-DTPA enhenced MRI and indocyanine green(ICG)retention test within a week were analyzed retrospectively.The patients were divided into indocyanine green retention at 15 minutes(ICG R_(1)5)<30% group in 86 patients and≥30%in 18 patients.T_(1) mapping images were acquired by the modified Look-Locker inversion recovery(MOLLI)sequence scanning before and at 10 and 20 minutes after enhancement,respectively.The T_(1) relaxation time at each time points were measured by selecting four region of intrerest(ROI)and then the reduction rate of T_(1) relaxation time(△T_(1)),T_(1) relaxation ratio(△R_(1)),HEF,and HEF uptake coefficient(K)were calculated.Independent samples t test was performed to compare T_(1) relaxation time,△T_(1),△R_(1),K and HEF values between different ICG R_(1)5 groups.And receiver operating characteristic(ROC)curve wavS done to characterize the diagnostic performance of T_(1) relaxation time,△T_(1),△R_(1),K and HEF values in different time points.Results With the increasing hepatic functional reserve damage,the Ti relaxation time value was increased(t=-4.751,-6.568 and-7.402),while the△T_(1),△R_(1),K and HEF values were decreased(t=7.901,8.846,7.905,8.991,9.074,10.931,8.193 and 10.063),which showed statistically significant differences between both groups(P<0.01).The area under the curve(AUC)of Ti relaxation time,△T_(1),△R_(1),K,and HEF at 20 minutes after enhancemen(0.935,0.926,0.93,0.944 and 0.944,respectively)were higher than those at 10 minutes(0.911,0.896,0.91,0.912 and 0.912,respectively).In addition,the HEF value at 20 minute after enhancemen had the best diagnostic value among above parameters(P<0.01).Conclusion Gd EOB-DTPA-enhanced T_(1) mapping imaging is an effective method to evaluate hepatic functional reserve.a

关 键 词：钆塞酸二钠 肝细胞增强分数 吲哚菁绿 肝脏储备功能 T1 mapping 

分 类 号：R814.43[医药卫生—影像医学与核医学] R322.47[医药卫生—放射医学]