磁共振弹性成像在评估肝脏功能储备中的应用：一项临床研究。
Use of magnetic resonance elastography for assessing liver functional reserve: A clinical study.
作者信息
Li Bin, Min Jie, Liang Wei-Ren, Zhang Guang-Qiang, Wu Jian-Jun, Jin Kai, Huang Wei, Ying Cai-Yu, Chao Ming
机构信息
Bin Li, Jie Min, Wei-Ren Liang, Guang-Qiang Zhang, Jian-Jun Wu, Kai Jin, Wei Huang, Cai-Yu Ying, Ming Chao, Department of Radiology, The Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou 310009, Zhejiang Province, China.
出版信息
World J Gastroenterol. 2015 Jun 28;21(24):7522-8. doi: 10.3748/wjg.v21.i24.7522.
AIM
To investigate the value of magnetic resonance elastography (MRE) with regard to assessing liver functional reserve.
METHODS
Data from inpatients diagnosed with a liver tumor at an interventional radiology department from July 2013 to June 2014 were analyzed. A 3.0 Tesla magnetic resonance unit was used to scan 32 patients with confirmed diagnoses of hepatocellular carcinoma (HCC); an MRE sequence was added to the protocol, and the data were reconstructed and analyzed by two attending radiologists. Regions of interest were identified in different slices of the non-tumor liver parenchyma to measure average stiffness. In addition, the indocyanine green (ICG) test was performed no more than 1 wk before or after the magnetic resonance examination for all 32 patients; the ICG retention rate at 15 min (ICGR-15) and the ICG plasma clearance rate (ICG-K) were recorded. Correlational analyses were performed between the liver stiffness values and the ICGR-15 as well as between the liver stiffness values and the ICG-K.
RESULTS
Magnetic resonance imaging, including an MRE sequence and the ICG test, was performed successfully in all 32 enrolled patients. None of the patients developed complications. The mean ± SD of the elasticity values measured by the two attending radiologists were 4.7 ± 2.2 kPa and 4.7 ± 2.1 kPa, respectively. The average liver stiffness value of the non-tumor parenchyma measured using MRE in HCC patients was 4.7 ± 2.2 kPa. The average ICGR-15 was 0.089 ± 0.077, and the average ICG-K was 0.19 ± 0.07. We found that the liver stiffness value of the non-tumor parenchyma was significantly and positively related to the ICGR-15 (r = 0.746, P < 0.01) as well as significantly and negatively related to the ICG-K (r = -0.599, P < 0.01). The ICGR-15 was significantly and negatively related to the ICG-K (r = -0.852, P < 0.01).
CONCLUSION
MRE is accurate and non-invasive; furthermore, it can be used to effectively assess the liver functional reserve of HCC patients.
目的
探讨磁共振弹性成像（MRE）在评估肝脏功能储备方面的价值。
方法
分析2013年7月至2014年6月在介入放射科诊断为肝肿瘤的住院患者的数据。使用3.0特斯拉磁共振设备对32例确诊为肝细胞癌（HCC）的患者进行扫描；在检查方案中增加MRE序列，并由两位放射科主治医师对数据进行重建和分析。在非肿瘤肝实质的不同层面确定感兴趣区，以测量平均硬度。此外，对所有32例患者在磁共振检查前或后1周内进行吲哚菁绿（ICG）试验；记录15分钟时的ICG滞留率（ICGR-15）和ICG血浆清除率（ICG-K）。对肝脏硬度值与ICGR-15以及肝脏硬度值与ICG-K之间进行相关性分析。
结果
所有32例入选患者均成功进行了包括MRE序列和ICG试验的磁共振成像检查。无患者发生并发症。两位放射科主治医师测量的弹性值的平均值±标准差分别为4.7±2.2 kPa和4.7±2.1 kPa。HCC患者使用MRE测量的非肿瘤实质的平均肝脏硬度值为4.7±2.2 kPa。平均ICGR-15为0.089±0.077，平均ICG-K为0.19±0.07。我们发现非肿瘤实质的肝脏硬度值与ICGR-15呈显著正相关（r = 0.746，P < 0.01），与ICG-K呈显著负相关（r = -0.599，P < 0.01）。ICGR-15与ICG-K呈显著负相关（r = -0.852，P < 0.01）。
结论
MRE准确且无创；此外，它可用于有效评估HCC患者的肝脏功能储备。
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