钆塞酸二钠增强MRI T1 mapping成像评估肝功能的价值  

The value of gadolinium ethoxybenzyl diethylenetriamine pentaacetic acid enhanced MRI T1 mapping in the evaluation of liver function

作　　者：张海燕 孟迪 高凌云[3] 种振 孙占国[3] ZHANG Haiyan;MENG Di;GAO Lingyun;ZHONG Zhen;SUN Zhanguo(Department of Imaging,Weishan County People’s Hospital,Jining,Shandong Province 277600,China;Clinical Medical College of Jining Medical University,Jining,Shandong Province 272029,China;Department of Medical Imaging,the Affiliated Hospital of Jining Medical University,Jining,Shandong Province 272029,China)

机构地区：[1]微山县人民医院影像科,山东济宁277600 [2]济宁医学院临床医学院,山东济宁272029 [3]济宁医学院附属医院医学影像科,山东济宁272029

出　　处：《实用放射学杂志》2025年第3期429-433,共5页Journal of Practical Radiology

摘　　要：目的探讨钆塞酸二钠(Gd-EOB-DTPA)增强MRI T1 mapping成像评估肝功能的临床应用价值.方法前瞻性纳入行Gd-EOB-DTPA增强MRI T1 mapping成像并在1周内完成肝功能相关实验室检查的患者64例,分为肝功能正常对照组(NCG)、肝功能Child-Pugh A级(CCA)组、肝功能Child-Pugh B级(CCB)组及肝功能Child-Pugh C级(CCC)组,将CCB+CCC组定义为肝功能中重度异常组.分别采集增强前、增强后_(10 min)及_(20 min)的T1 mapping图像,测量肝脏及脾脏各期的T1 mapping值,并计算T1弛豫时间减低率(ΔT1)和肝细胞增强分数(HEF).分析比较各参数在不同肝功能组别间的差异性,评价各指标鉴别不同肝功能组的诊断效能.结果T1_(平扫)、T1_(10 min)、T1_(20 min)、ΔT1_(10 min)、ΔT1_(20 min)、HEF_(10 min)、HEF_(20 min)在各组之间的差异均有统计学意义(P<0.05).T1_(平扫)在NCG与CCA组、NCG与CCB+CCC组之间的差异均有统计学意义(P<0.05),其鉴别肝功能正常组与肝功能异常组的曲线下面积(AUC)为0.761.T1_(10 min)、T1_(20 min)、ΔT1_(10 min)、ΔT1_(20 min)、HEF_(10 min)、HEF_(20 min)在CCA组与CCB+CCC组间差异有统计学意义,其鉴别2组的AUC分别为0.757、0.820、0.735、0.820、0.790、0.853,其中HEF_(20 min)的诊断效能最高.结论Gd-EOB-DTPA增强MRI T1 mapping成像可作为评估肝功能的一种有效方法.Objective To explore the clinical application value of gadolinium ethoxybenzyl diethylenetriamine pentaacetic acid(Gd-EOB-DTPA)enhanced MRI T1 mapping in the evaluation of liver function.Methods Sixty-four patients who underwent enhanced MRI T1 mapping with Gd-EOB-DTPA and completed the laboratory examination of liver function within one week were prospectively enrolled.All patients were divided into normal control group(NCG),cirrhosis Child-Pugh A(CCA)group,cirrhosis Child-Pugh B(CCB)group,and cirrhosis Child-Pugh C(CCC)group.CCB+CCC groups were defined as a moderate and severe abnormal liver function group.The T1 mapping images of pre-enhanced,post-enhanced _(10 min) and _(20 min) were collected,and the T1 mapping values of liver and spleen were measured.TheΔT1 and hepatocyte enhancement fraction(HEF)were calculated.The differences of parameters in different liver function groups were analyzed and compared,and the diagnostic efficacy of each index in distinguishing different liver function groups was evaluated.Results There were significant differences in T1_(plain scan),T1_(10 min),T1_(20 min),ΔT1_(10 min),ΔT1_(20 min),HEF_(10 min) and HEF_(20 min) among the three groups(P<0.05).The difference of T1_(plain scan) between NCG and CCA groups,and between NCG and CCB+CCC groups was statistically significant(P<0.05).The area under the curve(AUC)of differentiating normal liver function group from abnormal liver function group was 0.761.There were significant differences in T1_(10 min),T1_(20 min),ΔT1_(10 min),ΔT1_(20 min),HEF_(10 min) and HEF_(20 min) between CCA and CCB+CCC groups.The AUC of differentiating the two groups was 0.757,0.820,0.735,0.820,0.790 and 0.853,respectively,and HEF_(20 min) had the highest diagnostic efficacy.Conclusion Gd-EOB-DTPA enhanced MRI T1 mapping can be used as an effective method to evaluate liver function.

关 键 词：T1 mapping成像 钆塞酸二钠 肝功能 CHILD-PUGH评分 

分 类 号：R445.2[医药卫生—影像医学与核医学] R981.1[医药卫生—诊断学] R332.47[医药卫生—临床医学]