2型糖尿病对钆塞酸二钠增强MRI肝脏强化影响的研究  

Study on liver enhancement via gadolinium ethoxybenzyl diethylenetriamine pentaacetic acid enhanced MRI in patient with type 2 diabetes

作　　者：孙昊洋[1] 张文玉 杨天翔 SUN Haoyang;ZHANG Wenyu;YANG Tianxiang(Department of Radiology,the Affiliated Hospital of Shandong University of Traditional Chinese Medicine,Ji'nan 250001,China;Department of Radiology,Shandong Cancer Hospital and Institute,Shandong First Medical University and Shandong Academy of Medical Sciences,Ji'nan 250117,China;Department of Ultrasound,Haibei Prefecture Tibetan Hospital,Haibei,Qinghai Province 810200,China)

机构地区：[1]山东中医药大学附属医院放射科,山东济南250001 [2]山东省肿瘤防治研究院(山东省肿瘤医院)山东第一医科大学(山东省医学科学院)放射科,山东济南250117 [3]海北州藏医院B超室,青海海北810200

出　　处：《实用放射学杂志》2023年第8期1276-1279,共4页Journal of Practical Radiology

基　　金：北京康盟慈善基金会伦琴影像科研专项(SD-202008-017)。

摘　　要：目的探讨2型糖尿病对钆塞酸二钠(Gd-EOB-DTPA)增强MRI肝胆期的肝脏图像的影响。方法回顾性收集行肝脏Gd-EOB-DTPA增强MRI检查的52例患者的资料,将其分为观察组(2型糖尿病组)、对照组(无糖尿病组)。分析2组的肝胆期图像,计算肝脏相对增强比(LRE)、肝脏-肌肉增强比(LMR);2位医生分别进行肝脏-肾脏相对增强程度主观评分(LKS)。采用t检验或Wilcoxon秩和检验比较LRE、LMR、LKS的组间差异性。采用χ2检验比较2组LKS的构成比。采用受试者工作特征(ROC)曲线评价LRE、LMR、LKS鉴别2型糖尿病的效能。采用组内相关系数(ICC)评估LKS的观察者间一致性。结果观察组的LRE、LMR较对照组降低,2组LKS构成比不同,差异均有统计学意义(P<0.05)。LRE、LMR鉴别2型糖尿病的曲线下面积(AUC)分别为0.69、0.74;LKS无法鉴别2型糖尿病。LKS的ICC值为0.83。结论2型糖尿病能够降低Gd-EOB-DTPA增强MRI肝胆期的肝脏强化程度;LRE、LMR有助于鉴别2型糖尿病。Objective To investigate the effects of gadolinium ethoxybenzyl diethylenetriamine pentaacetic acid(Gd-EOB-DTPA)enhanced MRI on the liver images during the hepatobiliary phase in patient with type 2 diabetes.Methods The data of 52 patients who underwent the liver Gd-EOB-DTPA enhanced MRI were retrospectively collected.All subjects were divided into the observation group(type 2 diabetes group)and the control group(non-diabetes group).Hepatobiliary phase images were analyzed between the two groups.The liver-relative enhancement ratio(LRE)and the liver-muscle enhancement ratio(LMR)were calculated.The liver-kidney relative enhancement subjective score(LKS)was evaluated by two doctors.Differences between groups of LRE,LMR,and LKS were compared via the t-test or Wilcoxon rank-sum test.The x2 test was used to compare the constituent ratio of LKS between the two groups.The receiver operating characteristic(ROC)curve was used to evaluate the effectiveness of LRE,LMR,and LKS in differentiating type 2 diabetes.The intraclass correlation coefficient(ICC)was used to assess the inter-observer consistency of LKS.Results LRE and LMR in the observation group were significantly lower than those in the control group,and there was significant difference in constituent ratio of LKS between the two groups,and all the above differences were statistically significant(P<o.05).The area under the curve(AUC)of LRE and LMR in identifying type 2 diabetes was 0.69 and 0.74,respectively.LKS could not identify type 2 diabetes.The ICC value of LKS was O.83.Conclusion The degree of liver enhancement during the hepatobiliary phase can be reduced in patient with type 2 diabetes based on Gd-EOB-DTPA enhanced MRI.LRE and LMR can help to identify type 2 diabetes in clinical practice.

关 键 词：2型糖尿病 钆塞酸二钠 肝脏 磁共振成像 

分 类 号：R587.1[医药卫生—内分泌] R333.4[医药卫生—内科学] R445.2[医药卫生—临床医学]