钆塞酸二钠增强MRI评估全肝及各肝段肝功能

Gd-EOB-DTPA enhanced MRI in assessing whole liver and segmental liver function

目的探讨钆塞酸二钠(Gd-EOB-DTPA)增强MRI评估肝功能正常者及肝功能受损患者肝脏储备功能。方法将99例乙型肝炎肝硬化肝功能异常者分为Child-Pugh A级(Child-Pugh A级组;n=48)、B级(Child-Pugh B级组;n=40)、C级(Child-Pugh C级组;n=11),以21例无慢性肝病肝功能正常者为肝功能正常组(n=21)。行Gd-EOB-DTPA增强MRI,于注射对比剂后3min、10min、20min图像计算全肝及各肝段相对强化程度(RE),比较不同肝功能分组间、各肝段间(S1~S8)肝脏RE的差异。结果增强后3min、10min、20min,Child-Pugh A级、B级、C级组与肝功能正常组间全肝RE和各肝段RE总体差异均有统计学意义(P均<0.05)。增强后3 min、10 min、20 min,肝功能正常组及Child-Pugh A级组各肝段间RE差异均有统计学意义(P均<0.05),Child-Pugh B级组增强后10min、20min和Child-Pugh C级组增强后20min各肝段间RE差异有统计学意义(P均<0.05)。结论Gd-EOB-DTPA增强MRI可准确评估全肝及各肝段的功能。

Objective To investigate the value of gadolinium ethoxybenzyl diethylenetriamine pentaacetic acid（Gd-EOBDTPA）enhanced MRI in assessing liver reserve function in patients with normal liver function and abnormal liver function.Methods Totally 99 hepatitis B cirrhosis patients with abnormal liver function were classified into the following three groups,i.e.Child-Pugh A group（n=48）,Child-Pugh B group（n=40）,Child-Pugh C group（n=11）,while 21 patients without chronic liver disease were taken as normal liver function group.All patients underwent Gd-EOB-DTPA enhanced MRI.At 3 min,10 min and 20 min after intravenous administration of Gd-EOB-DTPA,the relative enhancement（RE）of whole liver and liver segments（S1—S8）was calculated,and the differences of liver RE were compared among different liver function groups and liver segments.Results At 3 min,10 min and 20 min after intravenous administration of GdEOB-DTPA,the differences of whole liver RE and segmental liver RE among the Child-Pugh A group,Child-Pugh B group,Child-Pugh C group and normal liver function group were statistically different（all P〈0.05）.At 3 min,10 min and 20 min after injection,RE of normal liver function group and Child-Pugh A group was significantly different among different liver segments（S1—S8）.At 10 min and 20 min after injection,RE of Child-Pugh B group was significantly different among different liver segments,while at 20 min after injection,RE of Child-Pugh C group was significantly different among different liver segments.Conclusion Gd-EOB-DTPA enhanced MRI can accurately assess whole liver and segmental liver function.