Tonan Tatsuyuki, Fujimoto Kiminori, Qayyum Aliya, Azuma Sanae, Ishibashi Masatoshi, Ueno Takato, Ono Noriyuki, Akiyoshi Junji, Matsushita Sunao, Hayabuchi Naofumi, Kawaguchi Takumi, Sata Michio
Departments of Radiology.
Exp Ther Med. 2011 Jul;2(4):607-613. doi: 10.3892/etm.2011.255. Epub 2011 Apr 11.
Kupffer cells contribute to the pathogenesis of liver injury in chronic liver disease, yet it is difficult to assess Kupffer cell function either ex vivo or in vivo, since supporting data are limited. The aim of this study was to clarify the relation between Kupffer cell function and hepatocyte function by analyzing the correlation between conventional indices of hepatic functional reserve and both superparamagnetic iron oxide-enhanced MRI (SPIO-MRI) and technetium-99m-galactosyl human serum albumin scintigraphy (Tc-99m-GSA) in patients with chronic viral hepatitis. Consecutive 46 patients (16 patients with chronic hepatitis and 30 patients with cirrhosis) who underwent both SPIO-MRI and Tc-99m-GSA were examined. The patients were aged 46-83 years (median 70) and included 29 men and 17 women. Spearman correlation coefficient was used to analyze the correlations between functional reserve indices and both reduction percentages of liver-to-muscle signal intensity ratio (reduction-%LMR), as a surrogate parameter of Kupffer cell function and Tc-99m-GSA parameters. The usefulness of each parameter as a marker to differentiate Child-Pugh A from Child-Pugh B/C was evaluated using receiver operating characteristic (ROC) analysis. The reduction-%LMR correlated more closely with Child-Pugh score (r=0.77; P<0.001) than did Tc-99m-GSA parameters. For predicting Child-Pugh B/C, ROC analysis revealed that reduction-%LMR (AUC=0.91, P<0.001) was the most useful parameter and at a cutoff value of 50% or less, sensitivity, specificity, positive and negative predictive values were 0.79, 0.91, 0.94 and 0.71, respectively. SPIO-MRI may be a helpful non-invasive method for the evaluation of hepatic functional reserve, and this study suggests that Kupffer cell function is closely correlated with hepatocyte function in patients with chronic viral hepatitis.
库普弗细胞在慢性肝病肝损伤的发病机制中起作用，但由于支持数据有限，很难在体外或体内评估库普弗细胞功能。本研究的目的是通过分析慢性病毒性肝炎患者肝功能储备的传统指标与超顺磁性氧化铁增强磁共振成像（SPIO-MRI）和锝-99m-半乳糖基人血清白蛋白闪烁显像（Tc-99m-GSA）之间的相关性，阐明库普弗细胞功能与肝细胞功能之间的关系。对连续46例同时接受SPIO-MRI和Tc-99m-GSA检查的患者（16例慢性肝炎患者和30例肝硬化患者）进行了研究。患者年龄在46-83岁（中位数70岁），包括29名男性和17名女性。采用Spearman相关系数分析功能储备指标与作为库普弗细胞功能替代参数的肝-肌信号强度比降低百分比（降低-%LMR）和Tc-99m-GSA参数之间的相关性。使用受试者工作特征（ROC）分析评估每个参数作为区分Child-Pugh A与Child-Pugh B/C的标志物的有用性。降低-%LMR与Child-Pugh评分的相关性（r=0.77；P<0.001）比Tc-99m-GSA参数更密切。对于预测Child-Pugh B/C，ROC分析显示降低-%LMR（AUC=0.91，P<0.001）是最有用的参数，在临界值为50%或更低时，敏感性、特异性、阳性和阴性预测值分别为0.79、0.91、0.94和0.71。SPIO-MRI可能是一种有助于评估肝功能储备的非侵入性方法，本研究表明慢性病毒性肝炎患者的库普弗细胞功能与肝细胞功能密切相关。
