Hitpass Lea, Amygdalos Iakovos, Sieben Paul, Raaff Vanessa, Lang Sven, Bruners Philipp, Kuhl Christiane K, Barabasch Alexandra
Department of Diagnostic and Interventional Radiology, RWTH Aachen University Hospital, Pauwelsstrasse 30, 52074 Aachen, Germany.
Department of Surgery and Transplantation, RWTH Aachen University Hospital, Pauwelsstrasse 30, 52074 Aachen, Germany.
J Clin Med. 2021 May 7;10(9):2003. doi: 10.3390/jcm10092003.
The aim of this study was to correlate the pre-procedural magnetic-resonance-imaging-based hepatic fat fraction (hFF) with the degree of hypertrophy after portal vein embolization (PVE) in patients with colorectal cancer liver metastases (CRCLM). Between 2011 November and 2020 February, 68 patients with CRCLM underwent magnetic resonance imaging (MRI; 1.5 Tesla) of the liver before PVE. Using T1w chemical shift imaging (DUAL FFE), the patients were categorized as having a normal (<5%) or an elevated (>5%) hFF. The correlation of hFF, age, gender, initial tumor mass, history of chemotherapy, degree of liver hypertrophy, and kinetic growth rate after PVE was investigated using multiple regression analysis and Spearman's test. A normal hFF was found in 43/68 patients (63%), whereas 25/68 (37%) patients had an elevated hFF. The mean hypertrophy and kinetic growth rates in patients with normal vs. elevated hFF were 24 ± 31% vs. 28 ± 36% and 9 ± 9 % vs. 8 ± 10% ( > 0.05), respectively. Spearman's test showed no correlation between hFF and the degree of hypertrophy (R = -0.04). Multivariable analysis showed no correlation between hFF, history of chemotherapy, age, baseline tumor burden, or laterality of primary colorectal cancer, and only a poor inverse correlation between age and kinetic growth rate after PVE. An elevated hFF in a pre-procedural MRI does not correlate with the hypertrophy rate after PVE and should therefore not be used as a contraindication to the procedure in patients with CRCLM.
本研究旨在探讨结直肠癌肝转移（CRCLM）患者门静脉栓塞术（PVE）前基于磁共振成像的肝脂肪分数（hFF）与肥大程度之间的相关性。2011年11月至2020年2月期间，68例CRCLM患者在PVE前接受了肝脏磁共振成像（MRI；1.5特斯拉）检查。使用T1w化学位移成像（DUAL FFE），将患者分为hFF正常（<5%）或升高（>5%）两类。采用多元回归分析和Spearman检验研究hFF、年龄、性别、初始肿瘤大小、化疗史、肝脏肥大程度和PVE后的动力学生长率之间的相关性。68例患者中43例（63%）hFF正常，25例（37%）hFF升高。hFF正常与升高的患者的平均肥大率和动力学生长率分别为24±31%对28±36%和9±9%对8±10%（>0.05）。Spearman检验显示hFF与肥大程度之间无相关性（R = -0.04）。多变量分析显示hFF、化疗史、年龄、基线肿瘤负荷或原发性结直肠癌的侧别之间无相关性，且仅年龄与PVE后的动力学生长率之间存在弱负相关。术前MRI显示hFF升高与PVE后的肥大率无关，因此不应将其作为CRCLM患者该手术的禁忌证。
