钆塞酸二钠增强磁共振肝胆特异期T1MappinNN肝脏损伤的价值

Value of gadoxetate disodium-enhanced magnetic resonance on hepatobiliary phase T1 mapping for predicting liver injury

目的评估钆塞酸二钠增强磁共振T1测量值对包括肝纤维化与炎症在内的肝脏损伤（LD）的预测能力。方法回顾性分析有病理结果115例患者的实验室数据，包括：凝血酶原时间（PT）、白蛋白、血浆总胆红素水平（TBfl）、丙氨酸氨基转移酶（ALT）、天冬氨基氨酸转移酶（AST）和磁共振测量值（增强前和肝胆特异期T1测量值即Tlpre、Tlpost和增强前后Tl弛豫时间的变化值）。LD与磁共振测量值之间的相关性由Spearman相关检验。将所有病例分为LD〈1和LD≥1两组（n1=26，n2=89），两组均数由t检验或Mann-WhitneyU检验比较。由logistic二元回归模型得出LD的独立影响因素。并进一步对Tlpre、Tlpost、变化值三者进行受试者工作特征曲线（ROC）分析，并计算曲线下面积（AUC）。结果Spearman检验显示，T1post和变化值与LD显著相关，相关系数分别是0．435、-0．353，P〈0．05。两组中Tlpost、变化值、PT、白蛋白、ALT和AST比较，差异均有统计学意义∽值均〈0．05）。Logistic二元回归模型显示T1post（P=0．006）、PT（P=0．003）、AST（P=0．032）是LD的独立影响因素。Tlpost能较好地预测肝脏损伤（AUC=0．800）。结论Tlpost有望预测是否存在肝脏损伤，为临床的诊断和治疗提供有用信息。

Objective To evaluate the measured value of gadoxetlc dlsodlum - eniaancecl Tl- weighted magnetic resonance for the prediction of liver damage （LD） including liver fibrosis and inflammation. Methods Retrospectively analyzed laboratory data of 115 patients with pathological results including prothrombin time （PT）, albumin, serum total bilirubin level （TBil）, alanine aminotransferase （ALT）, aspartate aminotransferase （AST）, and magnetic resonance measurements （T1 measurement before and after enhancement and hepatobiliary specific phase Tlpre, Tlpost, and changes in T1 relaxation time before and after enhancement were measured）. The correlation between LD and magnetic resonance measurements was assessed by Spearman＇s correlation. All cases were divided into two groups： LD 〈 1 and LD≥1 （nl = 26, n2 = 89）, and the mean value of both groups was compared by t-test or Mann-Whitney U test. The independent influence factors of LD were obtained by binary logistic regression model. The area under receiver operating characteristics （AUROC） curve was performed on Tlpre, Tlpost, and variation values. Results Spearman＇s correlation test showed that Tlpost and variation values were significantly associated with LD, and the correlation coefficients were 0.435, -0.353 and P 〈 0.05, respectively. The mean values of Tlpost, variation values, PT, albumin, ALT and AST were statistically significant （P 〈 0.05）. Binary logistic regression model showed Tlpost （P = 0.006）, PT （P = 0.003）, and AST （P - 0.032） were independent influencing factors of LD. T1- post contrast was good predictor of liver damage （AUC = 0.800）. Conclusion Tl-post contrast predicts the existence of liver damage and provides useful information for clinical diagnosis and treatment.