钆塞酸增强磁共振成像对大肝切除术后肝衰竭的预测价值。
Predictive value of gadoxetic acid enhanced magnetic resonance imaging for posthepatectomy liver failure after a major hepatectomy.
机构信息
Department of Gastroenterological Surgery I, Hokkaido University Graduate School of Medicine, Sapporo, Japan.
Department of Diagnostic and Interventional Radiology, Hokkaido University Hospital, Sapporo, Japan.
出版信息
J Hepatobiliary Pancreat Sci. 2020 Aug;27(8):531-540. doi: 10.1002/jhbp.769. Epub 2020 Jun 21.
BACKGROUND
We assessed the usefulness of gadolinium ethoxybenzyl diethylenetriamine pentaacetic acid enhanced magnetic resonance imaging for the prediction of posthepatectomy liver failure (PHLF) after a major hepatectomy.
METHODS
We reviewed 140 cases involving a hepatectomy of two or more sections between 2010 and 2016 (study cohort). We used the standardized remnant hepatocellular uptake index (SrHUI) which was calculated by: SrHUI = future remnant liver volume × [(signal intensity of remnant liver on hepatobiliary phase images/signal intensity of spleen on hepatobiliary phase images) - 1]/body surface area. Validation of the SrHUI was performed in another cohort of 52 major hepatectomy cases between 2017 and 2018 (validation cohort).
RESULTS
The SrHUI of patients with PHLF was significantly lower than that of non-PHLF cases. Receiver operating characteristic analysis and the Youden index revealed that the SrHUI cutoff value for the prediction of PHLF and PHLF grade ≥ B were 0.313 L/m and 0.257 L/m , respectively. In the validation cohort, the cutoff value of SrHUI for the prediction of PHLF or PHLF grade ≥ B had a sensitivity of 75.0% or 88.8%, and specificity of 78.1% or 91.6%, respectively.
CONCLUSIONS
The SrHUI value is a predictor for PHLF after a major hepatectomy.
背景
我们评估了钆乙氧苯甲基二乙三胺五乙酸增强磁共振成像在预测大范围肝切除术后肝衰竭（PHLF）中的作用。
方法
我们回顾了 2010 年至 2016 年间进行的 2 个或 2 个以上节段肝切除术的 140 例病例（研究队列）。我们使用标准化残肝细胞摄取指数（SrHUI）进行评估，SrHUI 计算公式为：SrHUI=未来残肝体积×[(肝实质期图像上残肝的信号强度/肝实质期图像上脾脏的信号强度)-1]/体表面积。在 2017 年至 2018 年间进行的另一个 52 例大范围肝切除术的队列中（验证队列），对 SrHUI 进行了验证。
结果
PHLF 患者的 SrHUI 明显低于非 PHLF 患者。受试者工作特征曲线分析和 Youden 指数显示，预测 PHLF 和 PHLF 分级≥B 的 SrHUI 截断值分别为 0.313 L/m 和 0.257 L/m。在验证队列中，SrHUI 对 PHLF 或 PHLF 分级≥B 的预测截断值的敏感性分别为 75.0%和 88.8%，特异性分别为 78.1%和 91.6%。
结论
SrHUI 值是预测大范围肝切除术后 PHLF 的一个指标。
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