Gd-EOB-DTPA增强MRI T1 mapping技术对肝功能评估的诊断价值  

The Diagnostic Performance of Gd-EOB-DTPA-Enhanced MRI T1 Mapping for Liver Function Assessment

作　　者：杨品 姜艳丽[1] 王鹏飞[1] 甘铁军 王瑞[1] 张静[1] YANG Pin;JIANG Yanli;WANG Pengfei(Department of MRI,Lanzhou University Second Hospital,Lanzhou,Gansu Province 730000,P.R.China)

机构地区：[1]兰州大学第二医院核磁共振科甘肃省功能及分子影像临床医学研究中心,730030

出　　处：《临床放射学杂志》2023年第5期773-777,共5页Journal of Clinical Radiology

基　　金：甘肃省科技计划项目(编号:21JR11RA122);兰州大学第二医院“萃英科技创新”计划(编号:CY2021-QN-B09)。

摘　　要：目的探讨Gd-EOB-DTPA增强MRI T_(1)mapping技术评估肝功能的价值。方法前瞻性搜集42例符合纳入排除标准患者的临床及影像学资料,按照Child-Pugh分级分为3组,Child-Pugh A级(LCA组)23例、Child-Pugh B级(LCB组)13例、Child-Pugh C级(LCC组)6例。测量肝组织增强前T1弛豫时间(T1_(pre))和信号强度(SI)、肝胆期T1弛豫时间(T_(1)HBP)和SI,分别计算增强前及肝胆期的肝脏/竖脊肌SI比值(SI_(pre),SI_(HBP)),计算肝脏T1弛豫时间减低率(△T1%)和相对肝脏强化率(RLE)。比较不同组间SI与T1定量参数间的差异,判断不同参数评估Child-Pugh B+C级的效能。使用Pearson相关分析各参数与吲哚菁绿15分钟滞留率(ICG R15)的相关性。结果T1_(pre)、T1_(HBP)、ΔT1%、SI_(pre)、SI_(HBP)、RLE诊断Child-Pugh B+C级的ROC曲线下面积分别为0.714、0.884、0.914、0.643、0.832、0.834。T1_(HBP)与ICG R15、Child-Pugh分数呈显著正相关(r=0.677,r=0.662,P<0.05)。结论T1_(HBP)与ICG R15、Child-Pugh分数不仅显著正相关,诊断性能优于ΔT1%与SI相关参数,对肝功能评估有重要价值。Objective To investigate the value of Gd-EOB-DTPA MRI T1 mapping in the evaluation of liver function.Methods This study prospectively collected the clinical and imaging data of 42 patients who met the inclusion and exclusion criteria,and divided them into three groups according to Child-Pugh classification:23 cases in the Child-Pugh grade A(LCA group),13 cases in the Child-Pugh grade B(LCB group),and Child-Pugh grade C(LCC group)6 cases.The T1 relaxation time(T1_(pre))and signal intensity(SI)of the liver before enhancement were measured,the liver T1 relaxation time(T1 _(HBP))and SI of hepatobiliary phase were measured;the SI ratio of liver/erector spinae(SIpre,S1HBP)before enhancement and hepatobiliary phase were calculated,respectively;the reduction rate of liver T1 relaxation time(△T1%)and relative liver enhancement rate(RLE)were calculated.The difference between SI and T1 quantitative parameters between different groups were compared,and the performance of different parameters in evaluating Child-Pugh B+C grade were analyzed.Pearman correlation coefficient was used to analyze the correlation between each parameter and indocyanine green retention rate at 15 min(ICG R15).Results The area under the curve of ROC of TIpre,T1_(HBP),△T1%,SIpre,SIHsp,and RLE diagnosing Child-Pugh B+C grade were 0.714,0.884,0.914,0.643,0.832,0.834,respectively.T1 _(HBP) was significantly positively correlated with ICG R15 and Child-Pugh scores(r=0.677,r=0.662,P<0.05).Conclusion TI HBp is not only significantly positively correlated with ICG R15 and Child-Pugh scores,but the diagnostic performance is better than △T1% and the correlation parameter of SI,which has an important value for liver function assessment.

关 键 词：磁共振成像 钆塞酸二钠 T1 mapping 肝功能 

分 类 号：R575[医药卫生—消化系统]