使用钆塞酸二钠增强3T磁共振成像的T1映射测量肝功能储备：与锝-99m半乳糖人血清白蛋白闪烁扫描法及基于信号强度的参数的初步比较研究
Measuring hepatic functional reserve using T1 mapping of Gd-EOB-DTPA enhanced 3T MR imaging: A preliminary study comparing with Tc GSA scintigraphy and signal intensity based parameters.
作者信息
Nakagawa Masataka, Namimoto Tomohiro, Shimizu Kie, Morita Kosuke, Sakamoto Fumi, Oda Seitaro, Nakaura Takeshi, Utsunomiya Daisuke, Shiraishi Shinya, Yamashita Yasuyuki
机构信息
Department of Diagnostic Radiology, Graduate School of Life Sciences, Kumamoto University, 1-1-1 Honjo, Chuoku, Kumamoto, 860-8556, Japan.
Department of Diagnostic Radiology, Graduate School of Life Sciences, Kumamoto University, 1-1-1 Honjo, Chuoku, Kumamoto, 860-8556, Japan.
出版信息
Eur J Radiol. 2017 Jul;92:116-123. doi: 10.1016/j.ejrad.2017.05.011. Epub 2017 May 10.
PURPOSE
To determine the utility of liver T1-mapping on gadolinium-ethoxybenzyl-diethylenetriamine-pentaacetic acid (Gd-EOB-DTPA) enhanced magnetic resonance (MR) imaging for the measurement of liver functional reserve compared with the signal intensity (SI) based parameters, technetium-99m-galactosyl serum albumin (Tc-GSA) scintigraphy and indocyanine green (ICG) clearance.
MATERIALS AND METHODS
This retrospective study included 111 patients (Child-Pugh-A 90; -B 21) performed with both Gd-EOB-DTPA enhanced liver MR imaging and Tc-GSA (76 patients with ICG). Receiver operating characteristic (ROC) curve analysis was performed to compare diagnostic performances of T1-relaxation-time parameters [pre-(T1pre) and post-contrast (T1hb) Gd-EOB-DTPA], SI based parameters [relative enhancement (RE), liver-to-muscle-ratio (LMR), liver-to-spleen-ratio (LSR)] and Tc-GSA scintigraphy blood clearance index (HH15)] for Child-Pugh classification. Pearson's correlation was used for comparisons among T1-relaxation-time parameters, SI-based parameters, HH15 and ICG.
RESULTS
A significant difference was obtained for Child-Pugh classification with T1hb, ΔT1, all SI based parameters and HH15. T1hb had the highest AUC followed by RE, LMR, LSR, ΔT1, HH15 and T1pre. The correlation coefficients with HH15 were T1pre 0.22, T1hb 0.53, ΔT1 -0.38 of T1 relaxation parameters; RE -0.44, LMR -0.45, LSR -0.43 of SI-based parameters. T1hb was highest for correlation with HH15. The correlation coefficients with ICG were T1pre 0.29, T1hb 0.64, ΔT1 -0.42 of T1 relaxation parameters; RE -0.50, LMR -0.61, LSR -0.58 of SI-based parameters; 0.64 of HH15. Both T1hb and HH15 were highest for correlation with ICG.
CONCLUSION
T1 relaxation time at post-contrast of Gd-EOB-DTPA (T1hb) was strongly correlated with ICG clearance and moderately correlated HH15 with Tc-GSA. T1hb has the potential to provide robust parameter of liver functional reserve.
目的
与基于信号强度（SI）的参数、锝-99m-半乳糖基血清白蛋白（Tc-GSA）闪烁扫描及吲哚菁绿（ICG）清除率相比，确定钆塞酸二钠（Gd-EOB-DTPA）增强磁共振（MR）成像上肝脏T1映射在测量肝脏功能储备方面的效用。
材料与方法
这项回顾性研究纳入了111例行Gd-EOB-DTPA增强肝脏MR成像及Tc-GSA检查（76例还进行了ICG检查）的患者（Child-Pugh A级90例；B级21例）。采用受试者操作特征（ROC）曲线分析比较T1弛豫时间参数[钆塞酸二钠预增强前（T1pre）及增强后（T1hb）]、基于SI的参数[相对增强（RE）、肝肌比（LMR）、肝脾比（LSR）]以及Tc-GSA闪烁扫描血清除指数（HH15）对Child-Pugh分级的诊断效能。采用Pearson相关性分析比较T1弛豫时间参数、基于SI的参数、HH15及ICG。
结果
T1hb、ΔT1、所有基于SI的参数及HH15在Child-Pugh分级方面存在显著差异。T1hb的曲线下面积（AUC）最高，其次是RE、LMR、LSR、ΔT1、HH15及T1pre。T1弛豫参数中与HH15的相关系数分别为：T1pre 0.22、T1hb 0.53、ΔT1 -0.38；基于SI的参数中分别为：RE -0.44、LMR -0.45、LSR -0.43。T1hb与HH15的相关性最高。与ICG的相关系数分别为：T1弛豫参数中T1pre 0.29、T1hb 0.64、ΔT1 -0.42；基于SI的参数中RE -0.50、LMR -0.61、LSR -0.58；HH15为0.64。T1hb及HH15与ICG的相关性均最高。
结论
Gd-EOB-DTPA增强后T1弛豫时间（T1hb）与ICG清除率密切相关，与Tc-GSA的HH15中度相关。T1hb有可能成为肝脏功能储备的可靠参数。
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