钆贝葡胺增强T_(1)mapping评价肝功能储备的价值  

Evaluation of the value of gadobenatedimeglumine enhanced T_(1) mapping in liver function reserve

作　　者：隋欣孜 王颖轩[2] 刘楷文 杨欢 王涛 王锡明 赵新亚 SUI Xinzi;WANG Yingxuan;LIU Kaiwen;YANG Huan;WANG Tao;WANG Ximing;ZHAO Xinya(Department of Medical Imaging, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan 250021, P.R.China;Department of Radiology, Shandong Tumor Hospital, Jinan 250117, P.R.China)

机构地区：[1]山东第一医科大学附属省立医院医学影像科,山东济南250021 [2]山东省肿瘤医院影像科,山东济南250117

出　　处：《医学影像学杂志》2022年第1期81-85,共5页Journal of Medical Imaging

基　　金：山东省自然科学基金项目(编号:ZR2020MH285)。

摘　　要：目的评估钆贝葡胺增强T_(1)mapping技术评价肝硬化患者肝功能储备的应用价值。方法选取2019年6月~2020年12月临床MRI检查中疑似肝脏局灶性病变的患者61例,根据Child-Pugh积分分为四组:Child-Pugh积分为A级、B级、C级的肝硬化患者组(LCA组、LCB组、LCC组)和肝功能正常的无肝硬化患者组(NLF组)。所有患者均行肝脏平扫及肝胆期钆贝葡胺增强的T_(1) mapping成像,并测量肝脏增强前后的T_(1)弛豫时间,计算T_(1)弛豫时间减低率(ΔT_(1))。应用单因素方差分析比较不同组间ΔT_(1)的差异,使用ROC曲线评价ΔT_(1)鉴别LCA组与LCB+LCC组、LCB组与LCC组的效能,采用Pearson相关系数分析ΔT_(1)与肝功能生化指标的相关性。结果LCB组、LCC组的ΔT_(1)均明显低于LCA组(P<0.05,P<0.001),LCB组、LCC组的ΔT_(1)明显低于NLF组(P<0.001,P<0.001),LCC组的ΔT_(1)明显低于LCB组(P<0.05)。ΔT_(1)鉴别LCA组和LCB+LCC组的ROC曲线下面积为0.792。ΔT_(1)鉴别LCB组和LCC组的ROC曲线下面积为0.895。ΔT_(1)与血清白蛋白(r=0.645,P<0.001)呈正相关,与凝血酶原时间(r=-0.620,P<0.001)、血清总胆红素(r=-0.505,P<0.001)呈负相关。结论钆贝葡胺增强T_(1) mapping技术对评价肝硬化患者的肝功能储备具有重要临床价值。Objective To investigate the value of T_(1) mapping on gadobenatedimeglumine(Gd-BOPTA-enhanced)MRI for the estimation of liver function reserve in patients with liver cirrhosis.Methods A prospective analysis was performed,61 patients with suspected focal liver lesions on MRI from June 2019 to December 2020 were collected.They were divided into four groups according to child-pugh grading liver cirrhosis patients with Child-Pugh Classes A,B,and C(the LCA,LCB,and LCC groups,respectively)and patients with normal liver function without liver cirrhosis(the NLF group).All patients underwent non-enhanced and Gd-BOPTA enhanced MRI scan.T_(1) relaxation time before and after liver enhancement was measured and the reduction rate of T_(1) relaxation time(ΔT_(1))was calculated.One-way analysis was used to compareΔT_(1) between the four groups(LCA,LCB,LCC,NLF).The receiver operating characteristic curve(ROC)was performed to evaluate the diagnosis efficacy ofΔT_(1) values in differentiating LCA from LCB+LCC and differentiating LCB from LCC.Pearson correlation coefficient was used to analyze the relationship betweenΔT_(1) of liver parenchyma and liver function parameters.ResultsΔT_(1) was significantly lower for LCB group and LCC group than LCA group(P<0.05,P<0.001)and NLF group(P<0.001,P<0.001),andΔT_(1) of LCC group was lower than that of LCB group(P<0.05).AUC ofΔT_(1) to distinguish LCBgroup+LCC group from LCA group was 0.792.AUC ofΔT_(1) to distinguish LCB group from LCC group was 0.895.ΔT_(1) was positively correlated with serum albumin(r=0.645,P<0.001),and negatively correlated with prothrombin time(r=-0.620,P<0.001)and serum total bilirubin(r=-0.505,P<0.001).Conclusion Gd-BOPTA-enhanced T_(1) mapping MRI has important clinical value in the evaluation of liver function reserve in patients with liver cirrhosis.

关 键 词：钆贝葡胺 磁共振成像 肝功能 对比剂 CHILD-PUGH分级 

分 类 号：R981[医药卫生—药品] R445.2[医药卫生—药学]