Li Xiu-Mei, Chen Zhu, Xiao En-Hua, Shang Quan-Liang, Ma Cong
Xiu-Mei Li, Zhu Chen, En-Hua Xiao, Quan-Liang Shang, Cong Ma, Department of Radiology, The Second Xiangya Hospital of Central South University, Changsha 410011, Hunan Province, China.
World J Gastroenterol. 2017 May 7;23(17):3133-3141. doi: 10.3748/wjg.v23.i17.3133.
To evaluate the diagnostic value of gadobenate dimeglumine (Gd-BOPTA)-enhanced hepatocyte-phase magnetic resonance imaging (MRI) in evaluating hepatic fibrosis and hepatitis.
Hepatocyte-phase images of Gd-BOPTA-enhanced MRI were retrospectively evaluated in 76 patients with chronic liver disease. These patients were classified into five groups according to either the histopathological fibrosis stage (S0-S4) or the histopathological hepatitis grade (G0-G4). The relative enhancement ratio (RE) of the liver parenchyma in the T1-vibe sequence was calculated by measuring the signal intensity before (SI pre) and 90 min after (SI post) intravenous injection of Gd-BOPTA using the following formula: RE = (SI post - SI pre)/SI pre. One-way analysis of variance was used to compare the difference between the relative RE in the hepatocyte phase (REh) and the stage of hepatic fibrosis and the grade of hepatitis. Pearson's product-moment correlation analysis was used to evaluate the relationship between the REh and the levels of serologic liver functional parameters.
According to histopathological hepatic fibrosis stage, the 76 patients were classified into five groups: 16 in S0, 15 in S1, 21 in S2, 9 in S3, and 15 in S4 group. According to histopathological hepatitis grade, the 76 patients were also classified into five groups: 0 in G0, 44 in G1, 22 in G2, 8 in G3, and 2 in G3 group. With regard to the stage of hepatic fibrosis, REh showed significant differences between the S2 and S3 groups and between the S2 and S4 groups ( < 0.05), but no significant difference was observed between the other groups. With regard to the grade of hepatitis, REh showed significant differences between the G1 and G2 groups and between the G1 and G4 groups ( < 0.05), but no significant difference was observed between the other groups. Increased REh showed correlations with decreased serum levels of TB, ALT and AST ( < 0.05).
To some extent, measuring the REh using Gd-BOPTA-enhanced MRI might be a noninvasive technique for assessing the stage of hepatic fibrosis. This method is able to differentiate no/mild hepatitis from advanced hepatitis. TB, ALT and AST levels can predict the degree of liver enhancement in the hepatocyte phase of Gd-BOPTA-enhanced MRI.
评估钆贝葡胺（Gd - BOPTA）增强肝细胞期磁共振成像（MRI）在评估肝纤维化和肝炎方面的诊断价值。
回顾性分析76例慢性肝病患者的Gd - BOPTA增强MRI肝细胞期图像。这些患者根据组织病理学纤维化分期（S0 - S4）或组织病理学肝炎分级（G0 - G4）分为五组。通过使用以下公式测量静脉注射Gd - BOPTA前（SI pre）和90分钟后（SI post）的信号强度，计算T1 - vibe序列中肝实质的相对增强率（RE）：RE =（SI post - SI pre）/ SI pre。采用单因素方差分析比较肝细胞期相对RE（REh）与肝纤维化分期和肝炎分级之间的差异。采用Pearson积矩相关分析评估REh与血清肝功能参数水平之间的关系。
根据组织病理学肝纤维化分期，76例患者分为五组：S0组16例，S1组15例，S2组21例，S3组9例，S4组15例。根据组织病理学肝炎分级，76例患者也分为五组：G0组0例，G1组44例，G2组22例，G3组8例和G3组2例。关于肝纤维化分期，REh在S2组和S3组之间以及S2组和S4组之间存在显著差异（<0.05），但其他组之间未观察到显著差异。关于肝炎分级，REh在G1组和G2组之间以及G1组和G4组之间存在显著差异（<0.05），但其他组之间未观察到显著差异。REh升高与血清TB、ALT和AST水平降低相关（<0.05）。
在一定程度上，使用Gd - BOPTA增强MRI测量REh可能是一种评估肝纤维化分期的非侵入性技术。该方法能够区分无/轻度肝炎与重度肝炎。TB、ALT和AST水平可预测Gd - BOPTA增强MRI肝细胞期肝脏增强程度。
