Gd-EOB-DTPA增强MRI定量评估肝脏储备功能的可行性研究

Evaluation of hepatic functional reserve on Gd-EOB-DTPA-enhanced MRI

目的:以吲哚氰绿(ICG)15、Child-Pugh评分及终末期肝病模型(MELD)评分为金标准,评估Gd-EOB-DTPA增强MRI定量评估肝脏储备功能的可行性。方法:本研究纳入15例肝脏肿瘤患者及12例肝功能正常志愿者。所有受试者在术前(4周内)均进行了Gd-EOB-DTPA增强MRI检查、ICG清除试验、Child-Pugh评分及MELD评分,以肝细胞摄取率(HUI)作为评估肝脏储备功能的指标。采用Spearmanrank相关检验分析HUI与ICG15、Child-Pugh评分及MELD评分的相关性。结果:HUI与ICG15呈负相关(r=-0.718,P=0.003);HUI与Child-Pugh评分呈负相关(r=-0.663,P=0.007);HUI与MELD评分呈负相关(r=-0.711,P=0.003)。12例小肝癌患者不同部位(肝左叶、右叶、尾叶)的HUI差异有统计学意义(P<0.05)结论:Gd-EOB-DTPA增强MRI可以定量评估肝脏储备功能,并且能对不同叶段的肝脏储备功能进行分别描述。

Objective： Based on the gold standard of indocyanine green （ICG） clearance at 15min,Child-Pugh score and MELD score,to quantitatively evaluate the hepatic functional reserve on Gd-EOB-DTPA-enhanced MRI. Methods：Fif- teen patients with hepatic tumors and 12 normal volunteers underwent ICG clearance test, Child-Pugh score, MELD score and Gd-EOB-DTPA enhanced MR examination for preoperative checkup. HUI, ICG15,Child-Pugh score and MELD score were evaluated with Spearman rank correlation analysis. Results： A significant negative correlation was observed between HUI and ICG15 （r=-0. 718,P=0. 003） ,between HUI and Child-Pugh score （r=-0. 663,P=0. 007） ,and between HUI and MELD score （r= -0. 711, P=0. 003）. There was statistical significant difference of HUI among the different sites （left lobe, right lobe and caudat lobe） of the small liver cancer in 12 cases （P〈0.05）. Conclusion： Gd-EOB-DTPA-enhanced MRI can quantitatively evaluate the hepatic functional reserve in different lobes or segments respectively.