Li Zhengjun, Zhang Fan, Lu Weiting, Lu Chao, Yuan Zheng, Wang Zhongqiu
Department of Radiology, Affiliated Hospital with Nanjing University of Traditional Chinese Medicine, Nanjing, Jiangsu, China.
Department of Infectious Diseases, Affiliated Hospital with Nanjing University of Traditional Chinese Medicine, Nanjing, Jiangsu, China.
Curr Med Imaging. 2025 Jun 23. doi: 10.2174/0115734056379090250611073434.
This study aimed to detect the performance of gadolinium ethoxybenzyl diethylenetriamine pentaacetic acid (Gd-EOB-DTPA)-enhanced magnetic resonance imaging (MRI) for assessing primary biliary cholangitis (PBC).
Seventy-five patients with PBC were included in this prospective study. Shear wave elastography (SWE) and Gd-EOB-DTPA-enhanced MRI were conducted, and then the signal intensity ratio (SIR) and contrast enhancement index (CEI) in different phases, including portal venous phase (PVP), equilibrium phase (EP), and hepatobiliary phase (HBP), were calculated. Afterward, the results were compared with Child-Pugh grading and non-invasive liver fibrosis models using the Kruskal-Wallis H test or Chi-squared test. The area under the curve (AUC) was applied to evaluate the diagnostic performance of SIR, CEI, and SWE across different Child-Pugh grades.
SWE (p<0.001), SIR (p<0.001), CEI (p<0.001), APRI (p=0.002), and FIB-4(p<0.001) showed significant differences in different Child-Pugh grades. Statistically significant differences were found in SIRHBP (p=0.005), CEI (p=0.010), and FIB-4 (p=0.001) of different SWE levels. For the diagnosis of Child-Pugh C, the AUC of SWE, SIR, and CEI were 0.889, 0.778, and 0.761, respectively. Correspondingly, the sensitivity was 75.0%, 64.4%, and 54.2%, and the specificity was 94.9%, 100%, and 100%, respectively. For the diagnosis of Child-Pugh B+C, the AUC of SWE, SIR, and CEI were 0.919, 0.809, and 0.814, respectively.
Our study confirmed that Gd-EOB-DTPA-enhanced MRI is an effective and objective method for assessing liver function in patients with PBC.
SIR and CEI could be regarded as a novel imaging biomarker to evaluate liver function. Gd-EOB-DTPA-enhanced MRI and SWE outperformed serum-based models in sensitivity and specificity, strengthening the value of imaging in clinical decision-making.
本研究旨在检测乙氧基苄基二乙烯三胺五乙酸钆（Gd-EOB-DTPA）增强磁共振成像（MRI）评估原发性胆汁性胆管炎（PBC）的性能。
75例PBC患者纳入本前瞻性研究。进行剪切波弹性成像（SWE）和Gd-EOB-DTPA增强MRI检查，然后计算不同期相（包括门静脉期（PVP）、平衡期（EP）和肝胆期（HBP））的信号强度比（SIR）和对比增强指数（CEI）。之后，使用Kruskal-Wallis H检验或卡方检验将结果与Child-Pugh分级和非侵入性肝纤维化模型进行比较。应用曲线下面积（AUC）评估SIR、CEI和SWE在不同Child-Pugh分级中的诊断性能。
SWE（p<0.001）、SIR（p<0.001）、CEI（p<0.001）、APRI（p = 0.002）和FIB-4（p<0.001）在不同Child-Pugh分级中显示出显著差异。不同SWE水平的SIRHBP（p = 0.005）、CEI（p = 0.010）和FIB-4（p = 0.001）存在统计学显著差异。对于Child-Pugh C级的诊断，SWE、SIR和CEI的AUC分别为0.889、0.778和0.761。相应地，敏感性分别为75.0%、64.4%和54.2%，特异性分别为94.9%、100%和100%。对于Child-Pugh B + C级的诊断，SWE、SIR和CEI的AUC分别为0.919、0.809和0.814。
我们的研究证实，Gd-EOB-DTPA增强MRI是评估PBC患者肝功能的一种有效且客观的方法。
SIR和CEI可被视为评估肝功能的新型影像学生物标志物。Gd-EOB-DTPA增强MRI和SWE在敏感性和特异性方面优于基于血清的模型，强化了影像检查在临床决策中的价值。
