【摘要】 目的探讨钆塞酸二钠(Gd-EOB-DTPA)特异性增强磁共振成像(MRI)评估一般人群肝功能的价值。方法筛选2013年6月-2014年9月在兰州大学第一医院接受1.5T MRI Gd-EOB-DTPA特异性增强扫描的患者,最终共纳入41例满足入组及排除标准的患者,获取其上腹部MRI平扫及Gd-EOB-DTPA增强扫描图像及部分临床信息。以脾脏作为肝脏信号强度的对照脏器,计算平扫及注射Gd-EOB-DTPA后10、20 min的肝-脾信号对比度(SI)、相对肝脏强化程度(RLE)。计量资料采用独立样本t检验或Mann-Whitney U检验,相关分析采用Spearman秩相关分析。结果注射造影剂10、20 min后的SI肝/脾与Child分级相关(P<0.05),且20 min SI肝/脾相关度更大(r=-0.526,P=0.003),而平扫SI肝/脾与Child分级无明显相关性(P>0.05);延迟20min后的RLE也与Child分级相关(r=-0.362,P=0.049),而延迟10 min后的RLE与Child分级无明显相关性。平扫时肝硬化组和非肝硬化组患者之间SI肝/脾差异无统计学意义(P>0.05),而注射造影剂10、20 min后的SI肝/脾、RLE20 min差异有统计学意义(P值均<0.05);增强扫描20 min后的SI肝/脾在ALT和TBil正常组与升高组之间差异都有统计学意义(P值均<0.05)。结论Gd-EOB-DTPA特异性增强扫描能够反映一般人群肝功能的变化,尤其是注射造影剂20 min后的SI肝/脾对评估肝功能有重要价值。更多还原

【Abstract】 Objective To explore the value of magnetic resonance imaging(MRI) specifically enhanced with gadolinium-ethoxybenzyl-diethylenetriamine pentaacetic acid(Gd-EOB-DTPA) in assessing the liver function in general population.Methods Upper abdominal MRI images and Gd-EOB-DTPA-enhanced images,as well as some clinical information,were collected from 41 cases meeting the inclusion and exclusion criteria.Taking the spleen as the control organ,liver-spleen signal intensity contrast(SIliver / spleen) and relative liver enhancement(RLE) were calculated at 10 min and 20 min after injecting Gd-EOB-DTPA.Differences were evaluated using the independent-samples t-test or Mann-Whitney U test.Corrections were analyzed via Spearman’s rank correlation.Results Both SIliver / spleenat 10 min and 20 min after injection of contrast agent were correlated with Child classification(P < 0.05).SIliver / spleenat 20 min had a greater correlation coefficient(r =-0.526) than that at 10 min.The SIliver / spleenwith plain scan had no significant correlation with Child classification(P > 0.05).RLE at 20 min,but not at 10 min,was correlated with Child classification(r =-0.362,P = 0.049).Between the cirrhotic and non-cirrhotic groups,SIliver / spleenshowed no significant difference(P > 0.05).However,SIliver / spleenat 10 min and 20 min,as well as RLE20 min,showed significant differences between the cirrhotic and non-cirrhotic groups(P < 0.05).SIliver / spleenat 20 min also exhibited a significant difference between the elevated and normal ALT and TBil groups(both P < 0.05).Conclusion Gd-EOB-DTPA-enhanced MRI can monitor liver function changes,and SIliver / spleenat 20 min may have an important value in assessing the liver function in general population.更多还原