Shen Li-Shan, Li Quan-Xi, Luo Xiao-Wen, Tang Hui-Jun, Tang You-Jie, Tang Wen-Jie, Guo Ruo-Mi
Department of Radiology, The Third Affiliated Hospital, Sun Yat-Sen University, Guangzhou 510635, China.
Diagnostics (Basel). 2021 Nov 18;11(11):2137. doi: 10.3390/diagnostics11112137.
To quantitatively investigate the correlation between liver fat content and hepatic perfusion disorders (HPD) after radiofrequency ablation (RFA) for liver cancer using magnetic resonance imaging (MRI)-determined proton density fat fraction (PDFF).
A total of 150 liver cancer patients underwent liver MRI examination within one month after RFA and at four months after RFA. According to the liver fat content, they were divided into non-, mild, moderate, and severe fatty liver groups. The liver fat content and hepatic perfusion disorders were determined using PDFF images and dynamic contrast-enhanced MRI images. The relationship between the liver fat content and HPD was investigated.
At the first postoperative MRI examination, the proportion of patients in the nonfatty liver group with hyperperfused foci (11.11%) was significantly lower than that in the mild (30.00%), moderate (42.86%), and severe fatty liver (56.67%) groups ( < 0.05), whereas the proportions of patients with hypoperfused foci (6.67%, 7.5%, 5.71%, and 6.67%, respectively) were not significantly different among the four groups ( > 0.05). In the nonfatty liver group, the liver fat content was not correlated with hyperperfusion abnormalities or hypoperfusion abnormalities. By contrast, in the three fatty liver groups, the liver fat content was correlated with hyperperfusion abnormalities but was not correlated with hypoperfusion abnormalities. At the second postoperative MRI examination, six patients in the nonfatty liver group were diagnosed with fatty liver, including two patients with newly developed hyperperfusion abnormalities and one patient whose hypoperfusion abnormality remained the same as it was in the first postoperative MRI examination.
There was a high correlation between the liver fat content and hyperperfusion abnormalities after RFA for liver cancer. The higher the liver fat content was, the higher the was risk of hyperperfusion abnormalities. However, there was little correlation between liver fat content and hypoperfusion abnormalities, and the increase in postoperative liver fat content did not induce or alter the presence of hypoperfused foci.
利用磁共振成像（MRI）测定的质子密度脂肪分数（PDFF），定量研究肝癌射频消融（RFA）后肝脏脂肪含量与肝灌注障碍（HPD）之间的相关性。
150例肝癌患者在RFA后1个月内及RFA后4个月接受肝脏MRI检查。根据肝脏脂肪含量，将他们分为非脂肪肝组、轻度脂肪肝组、中度脂肪肝组和重度脂肪肝组。使用PDFF图像和动态对比增强MRI图像测定肝脏脂肪含量和肝灌注障碍。研究肝脏脂肪含量与HPD之间的关系。
术后首次MRI检查时，非脂肪肝组出现高灌注灶的患者比例（11.11%）显著低于轻度（30.00%）、中度（42.86%）和重度脂肪肝组（56.67%）（P<0.05），而四组中出现低灌注灶的患者比例分别为6.67%、7.5%、5.71%和6.67%，差异无统计学意义（P>0.05）。在非脂肪肝组中，肝脏脂肪含量与高灌注异常或低灌注异常均无相关性。相比之下，在三个脂肪肝组中，肝脏脂肪含量与高灌注异常相关，但与低灌注异常无关。术后第二次MRI检查时，非脂肪肝组有6例患者被诊断为脂肪肝，其中2例出现新的高灌注异常，1例低灌注异常与术后首次MRI检查时相同。
肝癌RFA后肝脏脂肪含量与高灌注异常之间存在高度相关性。肝脏脂肪含量越高，发生高灌注异常的风险越高。然而，肝脏脂肪含量与低灌注异常之间几乎没有相关性，术后肝脏脂肪含量的增加并未诱导或改变低灌注灶的存在。
