基于MRI的肝功能评价在肝脏外科中的应用

Application of magnetic resonance imaging-based liver function assessment in hepatic surgery

肝功能是肝脏外科术前评估及预后判断的一项重要指标.临床常用的肝功能评估方法准确性不高,不能完全满足目前精准外科的要求.随着影像技术及对比剂的发展,利用肝特异性对比剂磁共振(magnetic resonance imaging,MRI)增强扫描获得全肝甚至肝段的肝功能成为可能.本文简述了目前肝功能的评价方法及其不足之处,阐述了肝细胞特异性MRI对比剂的原理,及应用其进行肝功能评估的各种方法及最新进展.基于肝特异性对比剂的MRI有望在不久的将来能够成为术前评价肝功能的新定量方法,达到肝脏精准外科对肝功能评估的精确要求.

Liver function is often assessed before liver surgery for surgical planning and prognosis prediction.The commonly used methods are not accurate as desired and cannot fully meet the clinical requirements.The advancement of imaging technology and contrast agents has made it possible to use liver-specific contrast agent-enhanced magnetic resonance imaging（MRI） to estimate the total and segmental liver function.Herein,we summarize several evaluation methods currently used and their shortcomings,and describe the principle of hepatic tissue-specific MRI contrast agents,a variety of relevant methods and the latest technological advances.The hepatic tissuespecific contrast-based MRI holds a promise to become a quantitative method for preoperative evaluation of liver function,and achieve the precise assessment of liver function that is needed for precise hepatic surgery.