Liu Chenxi, Sun Yan, Yang Yao, Feng Yuemin, Xie Xiaoyu, Qi Lingyu, Liu Keke, Wang Ximing, Zhu Qiang, Zhao Xinya
Department of Gastroenterology, Shandong Provincial Hospital, Cheeloo College of Medicine, Shandong University, Jinan, 250021, Shandong province, China.
Department of Gastroenterology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, 250021, Shandong province, China.
Eur Radiol. 2021 Aug;31(8):5840-5850. doi: 10.1007/s00330-021-07702-6. Epub 2021 Feb 3.
To determine the value of gadobenate dimeglumine (Gd-BOPTA)-enhanced biliary imaging from the hepatobiliary phase in predicting hepatic decompensation and insufficiency for patients with cirrhosis.
This single-center retrospective study included 270 patients who underwent Gd-BOPTA-enhanced magnetic resonance imaging. The relative enhancement ratios of the biliary system (REB) and liver parenchyma (REL) in patients with normal liver function without underlying chronic liver disease and three groups of patients with Child-Pugh A, Child-Pugh B, and Child-Pugh C disease were measured. After a mean follow-up of 38.5 ± 22.5 months, prognostic factors were evaluated using the Cox proportional hazards regression model. Receiver operating characteristic (ROC) curve analyses were performed to assess the capacity of the REB and REL to predict the development of hepatic decompensation and insufficiency.
During the follow-up period, nine of 79 patients with Child-Pugh A disease developed hepatic decompensation. The REB was a significant predictive factor (hazard ratio (HR) = 0.40 (0.19-0.84); p = 0.016), but the REL showed no association with hepatic decompensation. Moreover, the areas under the ROC curves (AUCs) were 0.83 and 0.52 for the REB and REL, respectively. Thirty-eight of 207 patients with cirrhosis developed hepatic insufficiency. The REB was a significant predictive factor (HR = 0.24 (0.13-0.46); p < 0.0001), but the REL did not show statistically significant association with hepatic insufficiency. The AUCs were 0.82 and 0.57 for the REB and REL, respectively.
Gd-BOPTA-enhanced biliary imaging from the hepatobiliary phase was valuable in predicting hepatic decompensation and insufficiency for cirrhotic patients.
• Gd-BOPTA-enhanced biliary imaging was a significant predictive factor for hepatic decompensation in patients with cirrhosis. • Gd-BOPTA-enhanced biliary imaging was a significant predictive factor for hepatic insufficiency in patients with cirrhosis. • Gd-BOPTA-enhanced biliary imaging showed superior predictive values for adverse clinical outcomes compared to liver parenchymal imaging at the hepatobiliary phase.
确定钆贝葡胺（Gd - BOPTA）肝胆期增强磁共振胆胰管成像在预测肝硬化患者肝失代偿和肝功能不全方面的价值。
这项单中心回顾性研究纳入了270例行Gd - BOPTA增强磁共振成像的患者。测量了无潜在慢性肝病的肝功能正常患者以及Child - Pugh A级、B级和C级三组肝硬化患者的胆道系统相对增强率（REB）和肝实质相对增强率（REL）。平均随访38.5±22.5个月后，使用Cox比例风险回归模型评估预后因素。进行受试者操作特征（ROC）曲线分析，以评估REB和REL预测肝失代偿和肝功能不全发生的能力。
在随访期间，79例Child - Pugh A级疾病患者中有9例发生肝失代偿。REB是一个显著的预测因素（风险比（HR）= 0.40（0.19 - 0.84）；p = 0.016），但REL与肝失代偿无关联。此外，REB和REL的ROC曲线下面积（AUC）分别为0.83和0.52。207例肝硬化患者中有38例发生肝功能不全。REB是一个显著的预测因素（HR = 0.24（0.13 - 0.46）；p < 0.0001），但REL与肝功能不全无统计学显著关联。REB和REL的AUC分别为0.82和0.57。
钆贝葡胺肝胆期增强磁共振胆胰管成像在预测肝硬化患者肝失代偿和肝功能不全方面具有重要价值。
•钆贝葡胺增强磁共振胆胰管成像对于肝硬化患者肝失代偿是一个显著的预测因素。•钆贝葡胺增强磁共振胆胰管成像对于肝硬化患者肝功能不全是一个显著的预测因素。•与肝胆期肝实质成像相比，钆贝葡胺增强磁共振胆胰管成像对不良临床结局显示出更高的预测价值。
