Yoo Hyunsuk, Lee Jeong Min, Yoon Jeong Hee, Kang Hyo-Jin, Lee Sang Min, Yang Hyun Kyung, Han Joon Koo
Department of Radiology, Seoul National University Hospital, Seoul 03080, Korea.
Institute of Radiation Medicine, Seoul National University Hospital, Seoul 03080, Korea.
Korean J Radiol. 2017 Jul-Aug;18(4):682-690. doi: 10.3348/kjr.2017.18.4.682. Epub 2017 May 19.
To evaluate the diagnostic value of T2 mapping using 3D multi-echo Dixon gradient echo acquisition on gadoxetic acid-enhanced liver magnetic resonance imaging (MRI) as a tool to evaluate hepatic function.
This retrospective study was approved by the IRB and the requirement of informed consent was waived. 242 patients who underwent liver MRIs, including 3D multi-echo Dixon fast gradient-recalled echo (GRE) sequence at 3T, before and after administration of gadoxetic acid, were included. Based on clinico-laboratory manifestation, the patients were classified as having normal liver function (NLF, n = 50), mild liver damage (MLD, n = 143), or severe liver damage (SLD, n = 30). The 3D multi-echo Dixon GRE sequence was obtained before, and 10 minutes after, gadoxetic acid administration. Pre- and post-contrast T2 values, as well as T2 reduction rates, were measured from T2 maps, and compared among the three groups.
There was a significant difference in T2 reduction rates between the NLF and SLD groups (-0.2 ± 4.9% vs. 5.0 ± 6.9%, = 0.002), and between the MLD and SLD groups (3.2 ± 6.0% vs. 5.0 ± 6.9%, = 0.003). However, there was no significant difference in both the pre- and post-contrast T2 values among different liver function groups ( = 0.735 and 0.131, respectively). A receiver operating characteristic (ROC) curve analysis showed that the area under the ROC curve for using T2 reduction rates to differentiate the SLD group from the NLF group was 0.74 (95% confidence interval: 0.63-0.83).
Incorporation of T2 mapping using 3D multi-echo Dixon GRE sequence in gadoxetic acid-enhanced liver MRI protocol may provide supplemental information for liver function deterioration in patients with SLD.
评估在钆塞酸增强肝脏磁共振成像(MRI)中使用三维多回波狄克逊梯度回波采集进行T2 mapping的诊断价值,以此作为评估肝功能的一种工具。
本回顾性研究经机构审查委员会(IRB)批准,豁免了知情同意的要求。纳入242例行肝脏MRI检查的患者,包括在3T场强下钆塞酸给药前后的三维多回波狄克逊快速梯度回波(GRE)序列。根据临床实验室表现,将患者分为肝功能正常(NLF,n = 50)、轻度肝损伤(MLD,n = 143)或重度肝损伤(SLD,n = 30)。在钆塞酸给药前及给药后10分钟获取三维多回波狄克逊GRE序列。从T2图测量对比前和对比后的T2值以及T2降低率,并在三组之间进行比较。
NLF组和SLD组之间的T2降低率有显著差异(-0.2±4.9%对5.0±6.9%,P = 0.002),MLD组和SLD组之间也有显著差异(3.2±6.0%对5.0±6.9%,P = 0.003)。然而,不同肝功能组之间对比前和对比后的T2值均无显著差异(分别为P = 0.735和0.131)。受试者工作特征(ROC)曲线分析显示,使用T2降低率区分SLD组和NLF组的ROC曲线下面积为0.74(95%置信区间:0.63 - 0.83)。
在钆塞酸增强肝脏MRI检查方案中纳入使用三维多回波狄克逊GRE序列的T2 mapping,可能为SLD患者肝功能恶化提供补充信息。