Department of Radiology, Affiliated Matern & Child Care Hospital of Nantong University, Nantong, 226000, Jiangsu, China.
Department of Radiology, Affiliated Nantong Hospital 3 of Nantong University, Nantong, 226000, Jiangsu, China.
Eur J Radiol. 2021 Aug;141:109779. doi: 10.1016/j.ejrad.2021.109779. Epub 2021 May 20.
This study aimed to assess the use of hepatocyte fraction in gadoxetic acid-enhanced magnetic resonance imaging (MRI) for quantitatively evaluating the liver function in comparison with T1 relaxation-based indices.
This retrospective study included 79 patients with chronic liver disease, who were divided into 2 groups based on the results of the indocyanine green retention test (ICG). All patients underwent a gadoxetic acid-enhanced MRI of the liver. Pre- and post-contrast Look-Locker sequences were used 20 min after gadoxetic acid administration to acquire T1 mapping. Two readers independently identified and measured the MRI parameters [five T1 relaxation-based indices (T1pre, T1post, rrT1, R1post/R1pre and ΔR1) and two hepatocyte fraction indices (HeF and K)]. An Independent-samples t test was used to compare each parameter for the two groups. Pearson correlation analysis was used to analyze the correction in each parameter and 15-minute ICG retention rate (ICG-R15). Receiver operating characteristic analyses were performed to differentiate the diagnostic performance of each parameter in ICG-R15 ≤ 20 % and ICG-R15 > 20 % groups.
T1pre and T1post were significantly lower in the ICG-R15 ≤ 20 % group than in the ICG-R15 > 20 % group (P < 0.05). rrT1, R1post/R1pre, ΔR1, HeF, and K were significantly higher in the ICG-R15 ≤ 20 % group than in the ICG-R15 > 20 % group (P < 0.05). The correction coefficients between T1pre, T1post, rrT1, R1post/R1pre, ΔR1, HeF, K, and ICG-R15 were 0.343, 0.783, -0.833, -0.781, -0.803, -0.819, and -0.832, respectively. The area under the curves (AUCs) of T1pre, T1post, rrT1, R1post/R1pre, ΔR1, HeF, and K in assessing the ICG-R15＞20 % groups were 0.761, 0.945, 0.912, 0.912, 0.948, 0.945, and 0.950, respectively. K had the highest AUC, sensitivity, and specificity.
Hepatocyte fraction based on gadoxetic acid-enhanced T1-mapping MRI is an efficient diagnostic tool for the quantitative evaluation of liver function.
本研究旨在评估基于钆塞酸增强磁共振成像（MRI）的肝细胞分数在定量评估肝功能方面的应用，并与基于 T1 弛豫时间的指数进行比较。
本回顾性研究纳入了 79 例慢性肝病患者，根据吲哚菁绿保留试验（ICG）的结果将其分为 2 组。所有患者均行钆塞酸增强肝脏 MRI 检查。在钆塞酸给药 20 分钟后，使用预对比和 Look-Locker 序列采集 T1 映射。两位读者独立识别并测量 MRI 参数[五个基于 T1 弛豫时间的指数（T1pre、T1post、rrT1、R1post/R1pre 和 ΔR1）和两个肝细胞分数指数（HeF 和 K）]。采用独立样本 t 检验比较两组间各参数的差异。采用 Pearson 相关分析分析各参数与 15 分钟 ICG 保留率（ICG-R15）的相关性。采用受试者工作特征曲线分析各参数在 ICG-R15≤20%和 ICG-R15>20%组的诊断效能。
ICG-R15≤20%组的 T1pre 和 T1post 明显低于 ICG-R15>20%组（P<0.05）。ICG-R15≤20%组的 rrT1、R1post/R1pre、ΔR1、HeF 和 K 明显高于 ICG-R15>20%组（P<0.05）。T1pre、T1post、rrT1、R1post/R1pre、ΔR1、HeF、K 与 ICG-R15 的校正系数分别为 0.343、0.783、-0.833、-0.781、-0.803、-0.819 和-0.832。T1pre、T1post、rrT1、R1post/R1pre、ΔR1、HeF 和 K 在评估 ICG-R15>20%组的曲线下面积（AUC）分别为 0.761、0.945、0.912、0.912、0.948、0.945 和 0.950。K 的 AUC、敏感度和特异度最高。
基于钆塞酸增强 T1 映射 MRI 的肝细胞分数是一种有效的肝功能定量评估诊断工具。
