The First Affiliated Hospital of Soochow University, Shizi street No. 188, Suzhou, 215006, Jiangsu, China.
Abdom Radiol (NY). 2018 Sep;43(9):2262-2269. doi: 10.1007/s00261-018-1462-y.
To determine if liver-to-portal vein contrast ratio (LPC) correlates with liver function in patients with hepatitis B virus (HBV)-related cirrhosis on gadolinium-ethoxybenzyl-diethylenetriamine penta-acetic acid (Gd-EOB-DTPA)-enhanced MR imaging.
A total of 92 patients with normal (n = 20) or HBV-related cirrhotic livers graded by Child-Pugh class A (n = 50), B (n = 17) or C (n = 5) who underwent Gd-EOB-DTPA-enhanced 3Tesla MR imaging were retrospectively reviewed. LPC was defined as the signal intensity ratio of liver parenchyma to portal vein on hepatobiliary phase (HBP) acquired at 20 min, and it was compared between normal and cirrhotic livers. The correlation between LPC and hepatic function parameters at HBP after injection was quantitatively analyzed as well.
LPC differed between normal and cirrhotic livers significantly (P < 0.001). LPC constantly and significantly decreased from normal to cirrhotic livers with Child-Pugh class C at HBP imaging (P < 0.001). Multiple regression analysis revealed that total bilirubin (P = 0.011), albumin (P < 0.001), and platelet count (P = 0.007) were independent predictors of LPC at HBP imaging. A receiver operating characteristic (ROC) curve analysis revealed that the optimal cutoff value for LPC to distinguish normal group from cirrhotic groups was 2.05 (AUC 0.98) with a sensitivity of 84.1% and a specificity of 100%.
The level of LPC on Gd-EOB-DTPA MR imaging can efficaciously indicate the severity of liver function in patients with HBV-related cirrhosis and was correlated with liver function parameters significantly. It might be used as an alternative imaging biomarker for assessing liver function.
在 Gd-EOB-DTPA 增强磁共振成像上，确定乙型肝炎病毒（HBV）相关肝硬化患者的肝门静脉对比率（LPC）与肝功能是否相关。
回顾性分析 92 例经 3.0T 磁共振成像 Gd-EOB-DTPA 增强扫描的患者，根据 Child-Pugh 分级，正常肝脏 20 例（A 级），HBV 相关肝硬化 50 例（B 级），17 例（C 级）。LPC 定义为肝胆期（HBP）20 分钟时肝实质与门静脉的信号强度比，并比较正常肝脏和肝硬化肝脏之间的 LPC。还定量分析了 LPC 与 HBP 后肝功能参数之间的相关性。
正常肝脏和肝硬化肝脏之间的 LPC 差异有统计学意义（P < 0.001）。LPC 在 HBP 成像上从正常到肝硬化 C 级逐渐显著降低（P < 0.001）。多元回归分析显示，总胆红素（P = 0.011）、白蛋白（P < 0.001）和血小板计数（P = 0.007）是 HBP 成像中 LPC 的独立预测因子。受试者工作特征（ROC）曲线分析显示，区分正常组和肝硬化组的最佳 LPC 截断值为 2.05（AUC 0.98），敏感性为 84.1%，特异性为 100%。
Gd-EOB-DTPA 磁共振成像上的 LPC 水平能有效反映 HBV 相关肝硬化患者肝功能的严重程度，与肝功能参数显著相关。它可能成为评估肝功能的替代成像生物标志物。
