Gd-EOB-DTPA增强磁共振肝胆特异期肝实质强化程度与临床化验指标相关性的研究

Clinical Laboratory Parameters Predicting the Insufficient Liver Enhancement on the Hepatocyte-Phase of Gd-EOB-DTPA-Enhanced Magnetic Resonance Imaging

目的探讨临床实验室指标对钆塞酸二钠（Gd-EOB-DTPA）增强磁共振肝实质肝胆特异期强化程度的影响。方法回顾性搜集195例行Gd-EOB-DTPA增强检查的患者资料,采用Pearson检验比较T1增强前后衰减率（Δ）与实验室检查指标,包括血浆总胆红素（TB）、白蛋白、丙氨酸转氨酶（ALT）、天冬氨酸转氨酶与血小板比率指数（APRI）的相关性,并进一步采用多因素线性回归模型分析其独立影响因素,对独立影响因素进行ROC曲线分析。结果Δ与TB、ALT、APRI呈负相关,相关系数分别为r=-0.470、-0.318、-0.397,P〈0.001;与白蛋白呈正相关,r=0.242,P=0.001;独立影响因素包括：回归系数TB（β=-0.370,P〈0.001）,白蛋白（β=0.139,P=0.036）,APRI（β=-0.157,P=0.041）;TB、白蛋白、APRI进行ROC曲线分析,三者的临界值分别为≤14.8 umol/L,〉40 g/L,≤1.1648。结论 Gd-EOB-DTPA增强肝胆特异期肝实质的强化程度受肝功能的影响,与临床评价肝功能的参数有一定相关性,TB、APRI的升高,白蛋白的减低可能预测肝实质的强化不足。

Objective To clarify the clinical parameters that predict the degree of hepatic parenchymal enhancement on gadolinium ethoxybenzyl diethylenetriamine pentaaeetic acid （Gd-EOB-DTPA）-enhanced magnetic resonance （MR） imaging in a relatively large sample of patients. Methods Gd-EOB-DTPA-enhaneed MR images of 195 patients were analyzed retrospectively. The reduction rate of the Tt relaxation time（A） of liver parenehymal was calculated from region of in- terest measurements at each patient. These results were then correlated with various clinical parameters using Pearson corre- lation coefficient. Furthermore, the predictor of the degree of hepatic parenehymal enhancement was determined using multi- ple regression analysis , and preformed ROC curve analysis. Results Total bilirubin （TB） （ r = - 0. 470, P 〈 0. 001 ） , albumin（r ：0. 242,P =0. 001 ）,alanine aminotransferase （ALT） （r = -0. 318 ,P 〈0.001 ）,and the AST to platelet ratio index （APRI） （r = -0. 397 ,P 〈 0. 001 ） were significantly correlated with A. Multiple regressions which showed the independent influence predictor were TB （13 = - 0. 370, P 〈 0.001 ）, albumin （13 = 0. 139, P = 0. 036 ） and APRI （13 = - 0. 157, P = 0. 041 ）, the cutoff value of TB albumin and APRI were≤ 14.8 μmo]/L, 〉 40 g/L, and ≤ 1. 1648. Conclusion The degree of hepatic parenchymal enhancement on the hepatocyte-phase of Gd-EOB-DTPA-enhaneed MRI was correlated with liver function parameters,increasing of TB, APRI and decreasing of albumin probably predict the insufficient liver enhancement on the hepatoeyte phase.