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钆塞酸二钠增强磁共振成像肝细胞期肝实质增强:哪些肝功能的生物学标志物会影响增强效果?

Liver parenchymal enhancement of hepatocyte-phase images in Gd-EOB-DTPA-enhanced MR imaging: which biological markers of the liver function affect the enhancement?

机构信息

Department of Radiology, University of Yamanashi, Chuo-shi, Japan.

出版信息

J Magn Reson Imaging. 2009 Nov;30(5):1042-6. doi: 10.1002/jmri.21956.

Abstract

PURPOSE

To clarify the factors that predict enhancement of the liver parenchyma in hepatocyte-phase of gadolinium ethoxybenzyl diethylenetriaminepentaacetic acid (Gd-EOB-DTPA)-enhanced MR imaging.

MATERIALS AND METHODS

Gd-EOB-DTPA-enhanced hepatocyte-phase MR images of 198 patients with chronic liver diseases (Child-Pugh class A in 112 patients, class B in 74 patients, and class C in 12 patients) were retrospectively analyzed. The hepatocyte-phase images were obtained using fat-suppressed T1-weighted gradient-echo images with a 3D acquisition sequence 10 min and 20 min after IV administration of Gd-EOB-DTPA (0.025 mmol/kg body weight). The quantitative liver-spleen contrast ratio (Q-LSC) was calculated using the signal intensities of the liver and spleen. Serum albumin levels, total bilirubin levels, prothrombin activity, and the results of indocyanine green clearance tests (ICGs) were recorded and correlated with the Q-LSC. Logistic regression analysis was performed to analyze which factors predict sufficient liver enhancement using a Q-LSC of 1.5 as a cutoff value.

RESULTS

Only ICGs and Child-Pugh classifications showed a statistically significant correlation with the Q-LSC. Logistic regression analysis showed that ICGs were the only factors that accurately predicted liver enhancement on hepatocyte-phase images.

CONCLUSION

ICGs were found to be predictors of sufficient liver enhancement on hepatocyte-phase images.

摘要

目的

阐明预测钆塞酸二钠(Gd-EOB-DTPA)增强磁共振成像肝细胞期肝实质增强的因素。

材料与方法

回顾性分析 198 例慢性肝病患者(Child-Pugh A 级 112 例、B 级 74 例、C 级 12 例)的 Gd-EOB-DTPA 增强磁共振成像肝细胞期图像。采用三维采集序列,静脉注射 Gd-EOB-DTPA(0.025mmol/kg 体重)后 10min 和 20min 行脂肪抑制 T1 加权梯度回波图像获取肝细胞期图像。采用肝脾信号强度计算定量肝脾对比比(Q-LSC)。记录血清白蛋白水平、总胆红素水平、凝血酶原活性及吲哚菁绿清除试验(ICG)结果,并与 Q-LSC 相关联。采用逻辑回归分析,以 Q-LSC 为 1.5 作为截断值,分析哪些因素可预测充足的肝脏增强。

结果

只有 ICGs 和 Child-Pugh 分级与 Q-LSC 具有统计学显著相关性。逻辑回归分析显示,ICG 是准确预测肝细胞期图像肝脏增强的唯一因素。

结论

ICG 是预测肝细胞期图像肝脏增强充足的预测因子。

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