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评估 HBV 相关 HCC 患者的肝功能:钆塞酸二钠增强 MRI 的 T₁ mapping 与 DWI 的比较。

Assessing liver function in patients with HBV-related HCC: a comparison of T₁ mapping on Gd-EOB-DTPA-enhanced MR imaging with DWI.

机构信息

Department of Radiology, Zhongshan Hospital of Fudan University, 180 Fenglin Road, Xuhui District, Shanghai, China, 200032,

出版信息

Eur Radiol. 2015 May;25(5):1392-8. doi: 10.1007/s00330-014-3542-x. Epub 2014 Dec 19.

Abstract

OBJECTIVES

To compare the potential of T1 mapping on gadoxetic acid (Gd-EOB-DTPA)-enhanced magnetic resonance imaging (MRI) and diffusion-weighted imaging (DWI) for assessing liver function in patients with hepatitis B virus (HBV)-related hepatocellular carcinoma (HCC).

METHODS

One hundred consecutive patients with known HBV-related HCCs were included. T1 relaxation time and apparent diffusion coefficient (ADC) of the liver were measured, and the reduction rate of T1 relaxation time (∆%) was calculated. T1 relaxation time measurements were compared with ADC values according to the Model for End-Stage Liver Disease (MELD) score.

RESULTS

Hepatobiliary phase (HBP) and ∆% of T1 relaxation time measurements showed significant correlations with MELD score (rho = 0.571, p < 0.0001; rho = -0.573, p < 0.0001, respectively). HBP and ∆% of T1 relaxation time were significantly different between good (MELD ≤8) and poor liver function (MELD ≥9) (p < 0.0001 for both). Areas under the receiver operating characteristic curves (AUCs) of T1 relaxation time for HBP (AUC 0.84) and ∆% (AUC 0.82) were significantly better than for ADC (AUC 0.53; p < 0.0001).

CONCLUSIONS

T1 mapping on Gd-EOB-DTPA-enhanced MRI showed promise for evaluating liver function in patients with HBV-related HCC, while DWI was not reliable. HBP T1 relaxation time measurement was equally accurate as ∆% measurement.

KEY POINTS

• T 1 mapping on Gd-EOB-DTPA MRI was accurate for assessing liver function. • HBP T 1 relaxation time measurement was as accurate as ∆% T 1 • T 1 mapping on Gd-EOB-DTPA MRI was more accurate than DWI-ADC measurement.

摘要

目的

比较钆塞酸(Gd-EOB-DTPA)增强磁共振成像(MRI)T1 mapping 与弥散加权成像(DWI)在乙型肝炎病毒(HBV)相关肝细胞癌(HCC)患者肝功能评估中的潜力。

方法

纳入 100 例已知 HBV 相关 HCC 患者。测量肝脏 T1 弛豫时间和表观扩散系数(ADC),并计算 T1 弛豫时间的降低率(%)。根据终末期肝病模型(MELD)评分比较 T1 弛豫时间测量值与 ADC 值。

结果

肝胆期(HBP)和 T1 弛豫时间的%测量值与 MELD 评分呈显著相关(rho=0.571,p<0.0001;rho=-0.573,p<0.0001)。HBP 和 T1 弛豫时间的%在肝功能良好(MELD≤8)和差(MELD≥9)的患者之间有显著差异(均 p<0.0001)。T1 弛豫时间 HBP(AUC 0.84)和%(AUC 0.82)的曲线下面积(AUC)明显优于 ADC(AUC 0.53;p<0.0001)。

结论

Gd-EOB-DTPA 增强 MRI 的 T1 映射有望评估 HBV 相关 HCC 患者的肝功能,而 DWI 不可靠。HBP T1 弛豫时间测量与%测量同样准确。

重点

  1. Gd-EOB-DTPA MRI 的 T1 映射可准确评估肝功能。

  2. HBP T1 弛豫时间测量与%T1 测量同样准确。

  3. Gd-EOB-DTPA MRI 的 T1 映射比 DWI-ADC 测量更准确。

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