Gd-EOB-DTPA增强MRI肝胆期全肝直方图分析评估肝脏储备功能的临床研究

Clinical Study of Gd-EOB-DTPA Enhanced MRI Hepatobiliary Whole Liver Histogram Analysis to Evaluate Liver Reserve Function

目的探讨基于钆塞酸二钠(Gd-EOB-DTPA)增强MRI肝胆期全肝直方图参数与肝功能不同分级之间的相关性。方法回顾性分析行上腹部MR平扫及Gd-EOB-DTPA增强MRI的94例慢性乙型肝炎肝硬化患者。根据Child-Pugh分级,将受试者分为:A级52例、B级29例和C级13例;根据MELD评分将患者分为MELD≤10组69例,MELD>10组25例。对全肝组织进行直方图分析,比较各直方图参数与Child-Pugh分级与MELD评分之间的相关性,并绘制受试者工作特征(ROC)曲线,评估相关参数诊断Child-Pugh≥B级的诊断效能。结果增加值(ΔMean、ΔMedian、Δ25th、Δ75th、Δ90th)与增加率(ΔMean%、ΔMedian%、Δ25th%、Δ75th%、Δ90th%)在不同Child-Pugh分级组间及不同MELD分组间均存在明显差异性(P均<0.001);ΔMean、ΔMedian、Δ25th、Δ75th、Δ90th和ΔMean%、ΔMedian%、Δ25th%、Δ75th%、Δ90th%与Child-Pugh分级及MELD评分均呈中等程度负相关(r=-0.496~-0.675)。ΔMean%、Δ75th%、Δ90th%诊断Child-Pugh≥B级患者效能较好,曲线下面积(AUC)分别为0.819、0.828、0.829。结论基于Gd-EOB-DTPA增强MRI全肝直方图分析有望成为一种新的无创性评估肝功能的影像学方法。

Objective To explore the correlation between the parameters of whole liver histogram and different grades of liver function based on Gd-EOB-DTPA enhanced MRI.Methods 94 patients with chronic hepatitis B cirrhosis who underwent upper abdominal MR plain scan and Gd-EOB-DTPA enhanced MRI in our hospital were analyzed retrospectively.According to the Child-Pugh grade,the patients were divided into 52 cases of A grade,29 cases of B grade and 13 cases of C grade.According to the MELD score,the patients were divided into 69 cases of MELD≤10,25 cases of MELD>10.The histogram of the whole liver tissue was analyzed,the correlation between the histogram parameters and Child-Pugh grade and MELD score was compared,and the ROC curve was drawn to evaluate the diagnostic efficiency of related parameters in the diagnosis of Child-Pugh≥B.ResultsΔMean,ΔMedian,Δ25th,Δ75th,Δ90th andΔMean%,ΔMed%,Δ25th,Δ75th%,Δ90th%were significant differences in among different Child-Pugh grade groups and different MELD groups(ALL P<0.001).ΔMean,ΔMedian,Δ25th,Δ75th,Δ90th andΔMean%,ΔMedian%,Δ25th%,Δ75th%,Δ90th%were a moderate negative correlation with Child-Pugh grade and MELD score.ΔMean%,Δ75th%,Δ90th%have better efficacy of in diagnosing Child-Pugh≥B patients was better,and the AUCs were 0.819,0.828 and 0.829 respectively.Conclusion Based on Gd-EOB-DTPA enhanced MRI whole liver histogram is expected to become a new kind of noninvasive imaging methods to assess function of liver.