Department of Radiology, Ajou University School of Medicine, Suwon, Republic of Korea; Department of Radiology, Institute of Gastroenterology, Research Institute of Radiological Science, Yonsei University Health System, Seoul, Republic of Korea.
J Magn Reson Imaging. 2014 Jan;39(1):24-30. doi: 10.1002/jmri.24100. Epub 2013 Apr 1.
To evaluate differences in liver enhancement among patients with low and high morbidity risks and to determine the relationship between severity of liver dysfunction and the relative ratio of liver to aortic enhancement (RE) on MRI using hepatocyte-specific contrast.
A total of 126 patients underwent magnetic resonance imaging (MRI) and blood serum testing including serology, bilirubin, international normalized ratio, and creatinine tests. Radiologists analyzed a region of interest in the liver and aorta on precontrast and 10- and 20-minute delayed hepatobiliary phase MR images. Liver enhancement after 10 (LE10min ) and 20 minutes (LE20min ) were compared between the low- and high-risk groups by independent t-test. Regression analysis was used to assess the relationship between the Model for Endstage Liver Disease (MELD) score and RE.
All 126 patients were classified into either the low-risk group (MELD <8; n = 85) or high-risk group (MELD ≥8; n = 41). The mean LE10min and LE20min were significantly higher in the low-risk group (471.61; 95% confidence interval [CI]: 449.79-493.43 and 510.69; 95% CI: 486.51-534.87, respectively) than in the high-risk group (401.6776; 95% CI: 364.75-438.61 and 413.81; 95% CI: 370.91-456.70). There was a moderate inverse correlation between MELD score and the relative ratio of liver enhancement (RLE) (r = -0.5442; 95% CI: -0.6480 to -0.4207; P<0.01), but a high positive correlation between MELD score and RE (r = 0.7470; 95% CI: 0.6665-0.8102; P < 0.01).
Although liver enhancement was significantly greater in low-risk patients compared to high-risk patients, RE may be a better predictor of liver function than RLE.
评估低和高发病率风险患者的肝增强差异，并使用肝特异性对比剂确定磁共振成像（MRI）中肝功能严重程度与肝与主动脉增强相对比值（RE）之间的关系。
共有 126 名患者接受了 MRI 和血清学、胆红素、国际标准化比值和肌酐检查。放射科医生在肝和主动脉的预对比及 10 分钟和 20 分钟延迟肝胆相期 MRI 图像上分析了感兴趣区域。通过独立 t 检验比较低风险组和高风险组的 10 分钟（LE10min）和 20 分钟（LE20min）后肝增强值。采用回归分析评估终末期肝病模型（MELD）评分与 RE 的关系。
所有 126 例患者均分为低风险组（MELD<8；n=85）或高风险组（MELD≥8；n=41）。低风险组的平均 LE10min 和 LE20min 显著高于高风险组（471.61；95%置信区间[CI]：449.79-493.43 和 510.69；95%CI：486.51-534.87）。MELD 评分与相对肝增强比值（RLE）之间存在中度负相关（r=-0.5442；95%CI：-0.6480 至-0.4207；P<0.01），但与 RE 之间存在高度正相关（r=0.7470；95%CI：0.6665-0.8102；P<0.01）。
尽管低风险患者的肝增强明显高于高风险患者，但 RE 可能比 RLE 更能预测肝功能。
