Department of Radiology, Montefiore Medical Center, Bronx, New York 10467, USA.
J Magn Reson Imaging. 2011 Aug;34(2):301-9. doi: 10.1002/jmri.22635. Epub 2011 May 23.
To identify factors influencing hepatobiliary phase (HBP) hepatic enhancement on gadoxetate disodium-enhanced MRI in patients with chronic liver disease (CLD).
We retrospectively reviewed abdominal gadoxetate disodium-enhanced MRIs and medical records of patients with (n=97) and without (n=48) CLD. CLD subgroups were formed based on normal/abnormal components of liver function tests (LFTs). Hepatic enhancement coefficients (HEKs) were calculated on MRI, and compared with LFTs and Model for End-stage Liver Disease (MELD) scores.
The mean HEK was significantly lower (P<0.0008) in the CLD than control group. The mean HEK was similar to controls in the subgroup with all normal LFTs (P=0.09) and subgroup with normal direct bilirubin (DB) (p=0.09), while it was significantly reduced (P<0.0001) in the subgroup with elevated DB. For all other LFT components, regardless of normal or abnormal values, there was a significant reduction in the mean HEKs versus controls (all P values<0.01). There was a highly negative correlation between the mean HEKs in CLD subgroups and number of abnormal LFTs (r=-0.93) and MELD scores (r=-0.89).
HBP hepatic enhancement in CLD patients is similar to those with no CLD as long as direct bilirubin remains normal. Higher MELD scores and higher number of abnormal LFT components are associated with reduced hepatic enhancement.
确定影响慢性肝病（CLD）患者钆塞酸二钠增强磁共振肝胆期（HBP）肝增强的因素。
我们回顾性分析了有（n=97）和无（n=48）CLD 的患者的腹部钆塞酸二钠增强 MRI 和病历。根据肝功能检查（LFTs）的正常/异常成分，将 CLD 亚组分组。在 MRI 上计算肝增强系数（HEK），并与 LFTs 和终末期肝病模型（MELD）评分进行比较。
CLD 组的平均 HEK 明显低于对照组（P<0.0008）。在所有 LFT 均正常的亚组（P=0.09）和直接胆红素（DB）正常的亚组（p=0.09）中，平均 HEK 与对照组相似，而在 DB 升高的亚组中，平均 HEK 明显降低（P<0.0001）。对于所有其他 LFT 成分，无论正常或异常值，与对照组相比，平均 HEK 均显著降低（所有 P 值<0.01）。CLD 亚组的平均 HEK 与异常 LFT 数量（r=-0.93）和 MELD 评分（r=-0.89）呈高度负相关。
只要直接胆红素保持正常，CLD 患者的 HBP 肝增强与无 CLD 患者相似。较高的 MELD 评分和较高的异常 LFT 成分数量与肝增强减少相关。
