采用钆塞酸二钠增强MRI肝胆期门静脉信号强度评价肝脏功能的临床价值

The value of signal intensity of portal vein at hepatobiliary phase on gadoxetic acid liver MRI enhancement for accessing the liver function

目的探讨钆塞酸二钠增强MRI肝胆期门静脉信号强度（SI）评价肝脏功能的临床价值。方法回顾性分析2015年1月至2016年6月苏州大学附属第一医院，疑似肝脏疾病接受钆塞酸二钠增强MRI检查的受试者95例，依据肝功能分为4组，分别为肝硬化Child-Pugh A级组（50例）、肝硬化Child-Pugh B级组（19例）、肝硬化Child-Pugh C级组（6例）和对照组（20例）。受试者均行上腹部MRI平扫及钆塞酸二钠增强扫描，记录平扫和肝胆期（延迟20 min）门静脉SI，并计算门静脉与脾脏SI比值。采用非参数Kruskal-Wallis检验比较4组患者间平扫和肝胆期门静脉与脾脏SI比值的差异，采用多元线性回归分析肝胆期门静脉与脾脏SI比值的相关预测因素。结果平扫各组间门静脉SI比值差异无统计学意义（P〉0.05）；增强扫描，肝胆期门静脉与脾脏SI比值差异有统计学意义（P〈0.05），随着肝功能损害程度的加重，肝胆期门静脉与脾脏SI比值升高。白蛋白和血小板计数是肝胆期门静脉与脾脏SI比值的独立预测因素（P值分别为0.002、0.007）。结论钆塞酸二钠增强MRI肝胆期门静脉与脾脏SI比值能够反映肝脏功能损害的严重程度，可用于评价肝功能。

ObjectiveTo investigate the value of the signal intensity of portal vein at hepatobiliary phase on gadoxetic acid liver enhancement imaging for accessing the liver function.MethodsNinety five subjects who underwent gadoxetic acid enhanced liver MR imaging due to suspicion of liver diseases between January 2015 and June 2016 at the First Hospital of Soochow University were retrospectively analyzed. Patients were classified into 4 groups based on their liver function： cirrhosis patients with Child-Pugh class A （n= 50）,B （n= 19）,C （n= 6） and control group （n=20）. All the patients had underwent the abdominal non-enhanced and gadoxetic acid enhanced MR imaging. The signal intensity （SI） of the portal vein at non-enhanced phase and hepatobiliary phase （delayed 20min） were recorded. The ratio of the portal vein to spleen were calculated. The nonparametric Kruskal-Wallis test was used to compare the differences in the SI of portal vein at non-enhanced and the ratio of portal vein to spleen at hepatobiliary phase among the four groups. Multiple regression analysis was applied to analyze the correlated predicting factors of the ratio of the portal vein to spleen at hepatobiliary phase.ResultsAt non-enhanced phase, the SI ratio of portal vein had no significant difference （P〉0.05）. The ratio of the portal vein to spleen at hepatobiliary was significantly different （P〈0.05）. The ratio of the portal vein to spleen at hepatobiliary constantly and significantly decreased as the severity of liver dysfunction increased. The serum levels of albumin and platelet count were independent predictors of the ratio of the portal vein to spleen at hepatobiliary phase （P= 0.002 and 0.007）.ConclusionsThe ratio of the portal vein to spleen at hepatobiliary phase on gadoxetic acid enhanced MR imaging indicates the severity of liver dysfunction. It might be used as a tool to assess the liver function.