钆塞酸二钠增强MRI与Child-Pugh分级及血清指标评价肝功能的对照研究

Comparison study of Gd-EOB-DTPA enhanced MRI with Child-Pugh classification and serum indies in assessing liver function

目的:探讨钆塞酸二钠(Gd-EOB-DTPA)增强核磁共振扫描(MRI)对肝实质相对强化程度(RE)的评估并将肝功能分级与血清指标进行对照研究.方法:收集Gd-EOB-DTPA MRI增强扫描病例资料共64例,按对照组与不同Child-Pugh等级分组,采用one-way ANOVA比较各组间RE值的差异,绘制受试者工作特征曲线(ROC)曲线分析RE值评估肝功能的效能,并观察Pearson相关系数检验RE值与各血清生化指标的相关性.结果:延迟期、肝胆细胞期组间RE值存在统计学差异(P <0. 05). ROC曲线显示对照组VS Child-Pugh A组+Child-Pugh B组+Child-Pugh C组延迟期、肝胆细胞期RE值曲线下面积(AUC)分别为0. 676、0. 702,对照组+Child-Pugh A组VS Child-Pugh B组+Child-Pugh C组延迟期、肝胆细胞期RE值AUC分别为0. 719、0. 819,对照组+Child-Pugh A组+Child-Pugh B组VS Child-Pugh C组延迟期、肝胆细胞期RE值AUC分别为0. 750、0. 859.肝胆细胞期RE值与ALB、GLB、TBIL、DBIL、TBA具有相关性(P <0. 05).结论:Gd-EOB-DTP MRI增强扫描肝胆细胞期RE值能评价肝脏受损的程度,具有较高的诊断效能,对评估肝功能具有一定临床意义.

Objective:To explore the clinical value of relative enhancement(RE)of liver parenchyma obtained by Gd-EOB-DTPA-enhanced MRI in evaluating liver function.Methods:Data of 64 patients with Gd-EOB-DTPA-enhanced MR scans were collected and were grouped by different Child-Pugh grade and control group.One-way ANOVA was used to compare the difference of RE between groups.ROC curve was drawn to analyze the diagnostic efficiency of RE in evaluating liver function.Pearson correlation coefficient was used to test the correlation between RE value and serum biochemical indices.Results:There was a significant difference in RE value between delayed phase group and hepatobiliary phase group(P<0.05).The ROC curve showed that the area under the curve(AUC)of RE value of delayed phase and hepatobiliary phase in control group VS Child-Pugh A group+Child-Pugh B group+Child-Pugh C group was 0.676 and 0.702,those in control group+Child-Pugh A group VS Child-Pugh B group+Child-Pugh C group was 0.719 and 0.819,and those in control group+Child-Pugh A group+Child-Pugh B group VS Child-Pugh C group was 0.750 and 0.859,respectively.The RE value of hepatobiliary phase was correlated with ALB,GLB,TBIL,DBIL and TBA(P<0.05).Conclusion:RE value of hepatobiliary phase obtained by Gd-EOB-DTP MRI enhanced scanning can evaluate the degree of liver damage,which has a high diagnostic efficiency and certain clinical significance for assessing liver function.