钆塞酸二钠增强MRI联合残余肝脏体积法在肝脏储备功能评估的价值

Application value of Gd-eob-dtpa enhanced MRI combined with residual liver volume assessment in assessment of pre-hepatectomy reserve function

目的分析钆塞酸二钠增强MRI联合残余肝脏体积法在肝脏储备功能评估的应用价值。方法选取肝脏局灶性病变患者100例,均拟行Gd-EOB-DTPA增强MRI检查,同时评估残余肝脏体积,对患者实施Child-Pugh分级,对不同Child-Pugh分级患者肝脏扫描情况、肝脏体积等进行分析,探索各指标间的相关性。结果与Child-Pugh A级患者比,Child-Pugh B级患者ICG-R15、总胆红素水平明显升高,白蛋白水平明显降低(P<0.05);Child-Pugh B级患者肝脏相对强化程度明显低于Child-Pugh A级患者(P<0.05);经Spearman行相关性分析,肝脏相对强化程度和ICG-R15为负相关,ICG-R15和肝脏相对强化程度、肝脏相对强化程度×肝脏体积、肝脏相对强化程度×残余肝脏体积比率的相关性逐渐增强。结论肝切除术前储备功能评估中,应用Gd-EOB-DTPA增强MRI联合残余肝脏体积评估法能够更准确的了解肝脏储备功能,为手术的实施做好准备。

Objective To analyze the value of Gd-eob-dtpa enhanced MRI combined with residual liver volume method in the assessment of reserve function before hepatectomy.Methods Gd-eob-dtpa enhanced MRI examination was performed in 100 patients with focal liver lesions,residual liver volume was evaluated,and child-pugh grading was performed on the patients.The liver scanning status and liver volume of patients with different child-pugh grading were analyzed to explore the correlation among the indicators.Results Compared with child-pugh grade A patients,icg-r15 and total bilirubin levels in child-pugh grade B patients were significantly increased,and albumin levels were significantly decreased(P<0.05).The degree of relative liver enhancement in child-pugh grade B patients was significantly lower than that in child-pugh grade A patients(P<0.05).Spearman correlation analysis showed that the relative strengthening degree of liver was negatively correlated with icg-r15,and the correlation between icg-r15 and relative strengthening degree of liver,relative strengthening degree of liver×liver volume,and relative strengthening degree of liver×residual liver volume ratio was gradually enhanced.Conclusion Gd-eob-dtpa enhanced MRI combined with residual liver volume assessment method can provide a more accurate understanding of liver reserve function in the assessment of pre-hepatectomy reserve function,and make preparations for the operation.