Wang Chao, Sun Wei-Rong, Wu Ning, Zhang Zhuang, Zhang Lai-Xing, Yi Wan-Qing, Yuan Xiao-Dong
Department of Graduate, Hebei North University, Zhangjiakou, China.
Department of Radiology, the 8th Medical Center of Chinese PLA General Hospital, Beijing, China.
Quant Imaging Med Surg. 2024 Feb 1;14(2):1904-1915. doi: 10.21037/qims-23-1147. Epub 2024 Jan 18.
The hepatocyte phase (HCP) in gadoxetic acid disodium (Gd-EOB-DTPA)-enhanced magnetic resonance imaging (MRI) plays an important role in the detection and characterization of liver lesions, treatment planning, and liver function evaluation. However, the imaging protocol is complicated and time-consuming. This cross-sectional study aimed to develop a convenient and reproducible protocol for the HCP acquisition in Gd-EOB-DTPA-enhanced MRI.
A total of 107 patients were prospectively included and assigned to three groups based on Child-Pugh (CP) classification, with 37, 40, and 30 in the non-cirrhosis, CP A, and CP B groups, respectively. Dynamic HCPs were acquired every 5 min after the Gd-EOB-DTPA administration and ended in 25 min in non-cirrhosis patients and 40 min in cirrhotic patients. The HCP acquired 5 min after the initial visualization of the intrahepatic bile duct (IBD) was selected from the dynamic HCPs as the adequate HCP (HCP) and the corresponding acquisition time was recorded as Time. In addition, according to the 2016 Expert Consensus (EC) on the definition of the adequate HCP from the European Society of Gastrointestinal and Abdominal Radiology (ESGAR), the adequate HCP and the corresponding Time were also determined from the dynamic HCPs. The hepatic relative enhancement ratio (RER), the contrast-to-noise ratio (CNR), and signal-to-noise ratio (SNR) of hepatic focal lesions in the HCP and HCP images, as well as the Time and Time were compared by the paired -test for the three groups, respectively. Inter-observer agreement of the determination of the HCP and HCP was compared by the χ test.
The RER, CNR, and SNR showed no significant difference between the HCP and HCP in all three groups (all P>0.05). The paired differences between Time and Time were 1.08±3.56 min (P=0.07), 2.88±4.22 min (P0.001), and 5.83±5.27 min (P0.001) in the three groups, respectively. Inter-observer agreement of the determination of the HCP and HCP were 0.804 (86/107) and 0.962 (103/107), respectively (χ²13.09, P=0.001).
The adequate HCP could be acquired 5 min after the initial visualization of the IBD, which could serve as a convenient and reproducible protocol for the HCP imaging.
钆塞酸二钠（Gd-EOB-DTPA）增强磁共振成像（MRI）中的肝细胞期（HCP）在肝脏病变的检测与特征分析、治疗方案规划及肝功能评估中发挥着重要作用。然而，成像方案复杂且耗时。本横断面研究旨在制定一种便捷且可重复的Gd-EOB-DTPA增强MRI中HCP采集方案。
前瞻性纳入107例患者，根据Child-Pugh（CP）分级分为三组，非肝硬化组37例、CP A组40例、CP B组30例。在注射Gd-EOB-DTPA后每5分钟采集动态HCP，非肝硬化患者采集25分钟，肝硬化患者采集40分钟。从动态HCP中选取肝内胆管（IBD）初次显影后5分钟采集的HCP作为合适的HCP（HCP），并记录相应的采集时间为Time。此外，根据欧洲胃肠道和腹部放射学会（ESGAR）2016年关于合适HCP定义的专家共识（EC），也从动态HCP中确定合适的HCP及其相应的Time。分别对三组HCP和HCP图像中肝脏局灶性病变的肝脏相对增强率（RER）、对比噪声比（CNR）和信噪比（SNR），以及Time和Time进行配对检验比较。通过χ检验比较观察者间对HCP和HCP判定的一致性。
三组中HCP和HCP之间的RER、CNR和SNR均无显著差异（均P>0.05）。三组中Time和Time的配对差异分别为1.08±3.56分钟（P=0.07）、2.88±4.22分钟（P<0.001）和5.83±5.27分钟（P<0.001）。观察者间对HCP和HCP判定的一致性分别为0.804（86/107）和0.962（103/107）（χ²=13.09，P=0.001）。
在IBD初次显影后5分钟即可采集到合适的HCP，这可作为一种便捷且可重复的HCP成像方案。
