T_(2)WI信号强度及钆贝葡胺增强MRI肝胆期参数评估肝硬化患者肝功能的价值  

Value of T_(2)WI signal intensity and gadobemeglumine enhanced MRI hepatobiliary phase parameters in evaluating liver function of cirrhosis patients

作　　者：林涛 杜涛明[1] 李亚 冯钰玲 宋惠贞 俞琴[1] Lin Tao;Du Taoming;Li Ya;Feng Yuling;Song Huizhen;Yu Qin(Department of Radiology,Chengdu Seventh People's Hospital,Chengdu 610000,China)

机构地区：[1]成都市第七人民医院放射科,四川成都610000

出　　处：《临床荟萃》2025年第3期251-256,共6页Clinical Focus

基　　金：2022年消化系统肿瘤与微环境实验室四川省高校重点实验室开放课题多模态MRI评估肝硬化患者肝功能的可行性价值(2022LHJYPJ-04)。

摘　　要：目的本研究旨在探讨T_(2)WI信号强度及钆贝葡胺(gadobenate dimeglumine,Gd-BOPTA)肝胆期参数与肝功能分级的相关性,并分别分析它们单独和联合诊断肝功能的价值。方法回顾性收集我院2019年6月-2024年9月行T_(2)WI及Gd-BOPTA增强MRI检查的肝硬化患者57例。在肝门层面,分别在T_(2)WI、平扫及肝胆期90 min MRI图像上,于肝左叶、肝右前叶及右后叶各放置大小相同感兴趣区域。测量T_(2)WI信号强度值(T_(2)WI signal intensity,SI_(T2))、T_(1)WI信号强度值(T_(1)WI signal intensity,SI_(平扫))及肝胆期信号强度(hepatobiliary phase signal intensity,SI_(肝胆期)),计算得到相对增强度(relative enhancement,RE)。比较不同Child-Pugh分级间各参数的差异;探讨各参数与Child-Pugh分级间的相关性;分析各有意义参数单独及联合诊断Child-Pugh B+C级的效能,同时比较各诊断效能间的差异性。结果不同Child-Pugh分级间的SI_(T2)、SI_(肝胆期)及RE差异均具有统计学意义(P<0.05)。SI_(T2)与Child-Pugh分级呈正相关(r=0.408,P=0.002);SI_(肝胆期)及RE均与Child-Pugh分级呈负相关(r=-0.365、-0.376,P=0.005、0.004);而SI_(平扫)与Child-Pugh分级不具有相关性(P=0.753);SI_(T2)、SI_(肝胆期)、RE及三者联合诊断Child-Pugh B+C组的AUC分别为0.715、0.707、0.757及0.846。SI_(T2)+SI_(肝胆期)+RE的AUC高于SI_(肝胆期),差异有统计学意义(P<0.05)。结论SI_(T2)、Gd-BOPTA肝胆期参数SI_(肝胆期)及RE与肝硬化患者肝功能分级相关,各自诊断肝功能分级有一定价值,三者联合诊断能拥有更高的效能。Objective To investigate the correlation of T2-weighted imaging(T_(2)WI)signal intensity and gadobenate dimeglumine(Gd-BOPTA)hepatobiliary phase(HBP)parameters with liver function grade,and to analyze their value in the diagnosis of liver function alone and combination.Methods A total of 57 cirrhosis patients who underwent enhanced magnetic resonance imaging(MRI)on T_(2)WI and Gd-BOPTA from June 2019 to September 2024 were retrospectively collected.At the hilar level,the region of interest(ROI)with the same size was placed on the left,right anterior and right posterior lobes of the liver on T_(2)WI,plain scan and 90-min MRI images of the hepatobiliary phase.The signal intensity of T_(2)WI(SI_(T2)),T_(1)WI(SIplain scan)and hepatobiliary phase(SI_(HBP))were measured,and relative enhancement(RE)was calculated.The parameters in cirrhosis patients possessing different Child-Pugh grades were compared.The correlation between the parameters and Child-Pugh grades was discussed.The diagnostic efficacy of Child-Pugh grade B+C was analyzed,and the difference between the diagnostic efficacy was compared.Results There were significant differences in SI_(T2),SI_(HBP)and RE among cirrhosis patients with different Child-Pugh grades(P<0.05).SI_(T2)was positively correlated with Child-Pugh classification(r=0.408,P=0.002).SI_(HBP)and RE were negatively correlated with Child-Pugh grade(r=-0.365,-0.376,P=0.005,0.004).However,there was no correlation between SI plain scan and the Child-Pugh grade(P=0.753).The area under the curve(AUC)of SI_(T2),SI_(HBP),RE and their combination in diagnosing Child-Pugh B+C cirrhosis was 0.715,0.707,0.757 and 0.846,respectively.The AUC of SI_(T2)+SI_(HBP+RE)was significantly larger than that of SI_(HBP)(P<0.05).Conclusion SI_(T2),Gd-BOPTA HBP parameters SI_(HBP)and RE are related to liver function grading in cirrhosis patients.Each possess a certain value in diagnosing liver function grading,and their combination reaches a higher efficiency.

关 键 词：肝硬化 T_(2)WI 钆贝葡胺 肝胆期 肝功能 

分 类 号：R575.2[医药卫生—消化系统]