肝特异性对比剂Gd-EOB-DTPA增强磁共振成像评价肝功能的研究进展

Assessment of liver function by Gd-EOB-DTPA enhanced magnetic resonance imaging

肝特异性对比剂Gd-EOB-DTPA的肝功能评价越来越受到重视,其吸收和排泄的路径与吲哚青绿15 min滞留实验及核素肝胆显像剂甲溴苯宁的吸收排泄路径相似即通过肝细胞膜表面的有机阴离子转运系统有机阴离子转运系统1(organic anion transporter 1,OATP1)B1和OATP1B3吸收进入肝细胞内,再通过多耐药蛋白载体排泄入胆道系统.GdEOB-DTPA增强磁共振(magnetic resonance,MR)优势在于常规的MR增强检查可同时获得肝功能信息,可以评价节段性肝功能且没有电离辐射损伤.其评价方法主要通过胆道内对比剂排泄的量、肝实质的强化率、MR弛豫时间的测定和灌注扫描参数的测定等,在评价肝功能储备、肝纤维化分级、非酒精性脂肪肝程度等有广泛的应用前景.

Gadolinium-ethoxybenzyl-diethylenetriamine pentaacetic acid（Gd-EOB-DTPA）,a liver-specific magnetic resonance imaging（MRI）contrast agent,is increasingly used for imaging-based liver function tests.Like indocyanine green and mebrofenin,Gd-EOBDTPA is taken up by hepatocytes through organic anion-transporting polypeptides 1（OATP_1）B_1 and B_3 and is then excreted into the bile by multi-drug resistance protein（MRP_2）.The advantages of Gd-EOB-DTPA-based liver function tests include function measurement integrated in an existing MRI protocol,ability of evaluating segmental liver function,and no ionizing radiation.The approaches based on Gd-EOB-DTPA for function measurement are as follows：measurement of biliary elimination,hepatic parenchymal enhancement,MR relaxometry,and MR perfusion.These approaches have potential value for assessing liver reserve,hepatic fibrosis,non-alcoholic fatty liver disease and so on.