摘要
目的：评价磁共振钆塞酸二钠增强肝胆期肝脏信号强度与肝脏功能关系。方法：本研究包括55例乙型肝炎肝硬化病人和对照组18例正常成人。所有受试者行肝脏功能实验室检查及Child-Pugh评分，并在注射钆塞酸二钠后行MR动态增强以及延迟5、10、15、20和25 min行MR肝胆期成像，测量各时间点肝脏、脾脏信号强度，分析对照组、Child-Pugh评分A级、B级病人之间在肝胆期各时间点上肝脏信号强度的绝对值、净增值、肝脏与脾脏信号强度比值的差异，并分析血清总胆红素、白蛋白水平和凝血酶原时间与这些信号强度之间的关系。结果：经Child-Pugh评分，A级35例，B级18例，C级2例。对照组和Child-Pugh A级、B级之间肝胆期各时间点信号强度的绝对值有显著差异（P≤0.006），信号强度净增值以及肝脏与脾脏信号强度比值也有显著差异（均为P≤0.001）。55例病人注射钆塞酸二钠后15、20和25 min肝脏信号强度绝对值无显著差异（F=0.121，P=0.886）。肝胆期肝脏信号强度与血清白蛋白之间呈正相关，而与血清总胆红素、凝血酶原时间之间呈负相关。结论：肝硬化病人MR钆塞酸二钠增强肝胆期肝脏信号强度反映肝细胞功能，并与血清白蛋白、总胆红素水平以及凝血酶原时间相关。延迟15 min的肝胆期MR图像已经可以反映肝细胞功能。
Abstract
Objective: To investigate the relationship between the liver signal intensity in the hepatobiliary phase in gadolinium ethoxybenzyl diethylenetriamine pentaacetic acid(gadoxetic acid, Gd-EOB-DTPA)-enhanced magnetic resonance imaging and liver function. Methods: This study included 55 patients with cirrosis due to hepatitis B and 18 adult normal as control group, the subjects received laboratory tests of liver function to perform the Child-Pugh score and MR imaging before injection and at 5, 10, 15, 20 and 25 minutes after bolus administration of Gd-EOB-DTPA, the signal intensities of liver and spleen at each time point were measured. The differences of the absolute value of liver, DSI(the differences of liver signal intensity between the hepatobiliary phase and plain scan), liver-to-spleen contrast ratio were analysed. The relationships between the signal intensity and total bilirubin level, albumin level, and prothrombin time were also evaluated. Results: According to the Child-Pugh score, there were 35 patients in Child-Pugh A group, 18 in B group and 2 in C group. The signal intensity, DSI, and liver-to-spleen contrast ratio showed significant differences among the control group, Child-Pugh A group and Child-Pugh B group at each time point. There were no differences of the liver signal intensity at 15, 20 and 25 minutes in 55 patients(F=0.121, P=0.886). Liver signal intensity in hepatobiliary phase positively correlated with and serum albumin level and negtively correlated with the total bilirubin level, prothrombin time. Conclusion: The degree of liver enhancement in hepatobiliary phase may be used to estimated liver function and correlate with the serum albumin level, total bilirubin level, prothrombin time. The delay time of 15 minutes was suitable for liver functional assessment.
关键词
肝硬化 /
磁共振成像
Key words
Liver cirrhosis /
Magnetic resonance imaging
金腊梅;吴建伟;瞿献莉;高 红;张 艳;卢光明.
磁共振钆塞酸二钠增强评价肝脏功能可行性研究[J]. 中国临床医学影像杂志. 2013, 24(9): 630-634
JIN La-mei;WU Jian-wei;QU Xian-li;GAO Hong;ZHANG Yan;LU Guang-ming.
Feasibility study of evaluation of liver function using Gd-EOB-DTPA-enhanced MR imaging[J]. Journal of China Clinic Medical Imaging. 2013, 24(9): 630-634
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