Nakamura Masafumi, Takatsu Yasuo, Yoshizawa Mutsumi, Kobayashi Satoshi, Miyati Tosiaki
Department of Radiological Technology, Faculty of Health and Welfare, Tokushima Bunri University, 1314-1, Shido, Sanuki, Kagawa, 769-2193, Japan.
Division of Health Sciences, Graduate School of Medical Sciences, Kanazawa University, 5-11-80 Kodatsuno, Kanazawa, Ishikawa, 920-0942, Japan.
Radiol Phys Technol. 2025 Mar;18(1):147-156. doi: 10.1007/s12194-024-00868-w. Epub 2024 Dec 3.
To determine whether visually observed biliary excretion of gadolinium-ethoxybenzyl-diethylenetriamine pentaacetic acid (Gd-EOB-DTPA) can be used to assess contrast adequacy of hepatobiliary phase (HBP) images. Images of 121 patients undergoing Gd-EOB-DTPA-enhanced magnetic resonance imaging were used. Adequate HBP images were defined as a quantitative liver-spleen contrast ratio (Q-LSC) ≥ 1.5. Visual evaluation was performed to determine if an adequate HBP image could be obtained based on the presence or absence of bile excretion. Common bile duct-paravertebral contrast (CPC) was used to assess the degree of bile excretion, the albumin-bilirubin (ALBI) grade was used to assess liver reserve, and the Q-LSC was used to assess HBP image contrast. The results were used to quantitatively evaluate the relationships of the degree of bile excretion with HBP image contrast and liver reserve. The cases correctly determined by visual evaluation via bile excretion were 80 (66.1%) at HBP 10 min after injection and 89 (73.6%) at HBP 20 min after injection. Among cases with Q-LSC ≥ 1.5 indicating bile excretion, there were 33 cases at HBP 10 min after injection and 86 cases at HBP 20 min after injection. Furthermore, among cases with Q-LSC < 1.5, indicating no bile excretion, there were 47 cases at HBP 10 min after injection and 3 cases at HBP 20 min after injection. Visually observed biliary excretion of Gd-EOB-DTPA is not a criterion for adequate HBP image contrast.
为了确定通过视觉观察钆-乙氧基苄基-二乙三胺五乙酸（Gd-EOB-DTPA）的胆汁排泄情况是否可用于评估肝胆期（HBP）图像的对比剂充盈情况。使用了121例接受Gd-EOB-DTPA增强磁共振成像的患者的图像。将充足的HBP图像定义为定量肝脾对比率（Q-LSC）≥1.5。进行视觉评估以根据胆汁排泄的有无来确定是否可获得充足的HBP图像。使用胆总管-椎旁对比（CPC）来评估胆汁排泄程度，使用白蛋白-胆红素（ALBI）分级来评估肝脏储备，使用Q-LSC来评估HBP图像对比。结果用于定量评估胆汁排泄程度与HBP图像对比及肝脏储备之间的关系。通过胆汁排泄的视觉评估正确判定的病例在注射后10分钟的HBP时为80例（66.1%），在注射后20分钟的HBP时为89例（73.6%）。在Q-LSC≥1.5且提示胆汁排泄的病例中，注射后10分钟的HBP时有33例，注射后20分钟的HBP时有86例。此外，在Q-LSC＜1.5且提示无胆汁排泄的病例中，注射后10分钟的HBP时有47例，注射后20分钟的HBP时有3例。视觉观察到的Gd-EOB-DTPA的胆汁排泄情况并非充足的HBP图像对比的标准。
