CAJ | 학술논문

目的探讨肝功能对钆塞酸二钠(Gd-EOB-DTPA)增强MRI肝胆期肝脏强化程度的影响.方法回顾性分析67例行MR平扫及注射Gd-EOB-DTPA后延迟5、10和20 min肝胆期成像的肝硬化患者的影像资料,按照Child-Pugh分级分为3组:A级组42例,B级组20例,C级组5例.测量各时间点肝脏相对强化程度(RE),记录相关实验室检查结果,包括总胆红素(TB)、白蛋白(Alb)和凝血酶原时间(PT).采用单因素方差分析比较肝胆期各时间点3组间的RE,两两比较采用SNK法,采用Pearson法分析所有患者肝胆期各时间点RE与实验室检查结果的关系.结果 Child-Pugh A级组肝胆期各时间点RE依次为:1.59±0.20、1.65±0.22、1.69±0.25,B级组依次为1.47±0.14、1.48±0.18、1.50±0.22,C级组依次为1.35±0.07、1.27±0.06、1.26±0.06,3组间差异均有统计学意义(F值分别为5.854、11.207和9.666,P值均＜0.01).A、C级组各时间点RE的差异有统计学意义(P值均＜0.01),B、C级组10及20 min RE的差异有统计学意义(P值均＜0.05),A、B级组10 min RE的差异有统计学意义(P＜0.05).不同肝功能分级组间实验室检查结果的差异也有统计学意义(P值均＜0.01).延迟10及20 min的RE与TB呈中度负相关(r值分别为-0.483和-0.500,P值均＜0.叭),与PT呈低度负相关(r值分别为-0.326和-0.351,P值均＜0.01),与Alb呈低度正相关(r值分别为0.290和0.292,P值均＜0.05).结论 RE在不同肝功能患者间存在差异,且与TB、Alb及PT具有相关性,可在一定程度上反映肝功能.
목적 탐토간공능대구새산이납(Gd-EOB-DTPA)증강MRI간담기간장강화정도적영향.방법 회고성분석67례행MR평소급주사Gd-EOB-DTPA후연지5、10화20 min간담기성상적간경화환자적영상자료,안조Child-Pugh분급분위3조:A급조42례,B급조20례,C급조5례.측량각시간점간장상대강화정도(RE),기록상관실험실검사결과,포괄총담홍소(TB)、백단백(Alb)화응혈매원시간(PT).채용단인소방차분석비교간담기각시간점3조간적RE,량량비교채용SNK법,채용Pearson법분석소유환자간담기각시간점RE여실험실검사결과적관계.결과 Child-Pugh A급조간담기각시간점RE의차위:1.59±0.20、1.65±0.22、1.69±0.25,B급조의차위1.47±0.14、1.48±0.18、1.50±0.22,C급조의차위1.35±0.07、1.27±0.06、1.26±0.06,3조간차이균유통계학의의(F치분별위5.854、11.207화9.666,P치균＜0.01).A、C급조각시간점RE적차이유통계학의의(P치균＜0.01),B、C급조10급20 min RE적차이유통계학의의(P치균＜0.05),A、B급조10 min RE적차이유통계학의의(P＜0.05).불동간공능분급조간실험실검사결과적차이야유통계학의의(P치균＜0.01).연지10급20 min적RE여TB정중도부상관(r치분별위-0.483화-0.500,P치균＜0.팔),여PT정저도부상관(r치분별위-0.326화-0.351,P치균＜0.01),여Alb정저도정상관(r치분별위0.290화0.292,P치균＜0.05).결론 RE재불동간공능환자간존재차이,차여TB、Alb급PT구유상관성,가재일정정도상반영간공능.
Objective To evaluate the effect of liver function on liver enhancement in hepatobiliary phase of gadolinium ethoxybenzyl diethylenetriamine pentaacetic acid(Gd-EOB-DTPA)-enhanced MRI.Methods Sixty-seven patients who suffered from cirrhosis and received enhanced MRI with Gd-EOB-DTPA were retrospectively analyzed,and divided into three subgroups according to ChildPugh score(45 patients in group A,20 in group B,5 in group C).All the individuals of both groups had MRI before injection,and hepatobiliary phase images were obtained at 5,10,and 20 minutes after bolus administration of Gd-EOB-DTPA.The relative enhancement(RE) was calculated by dividing the signal intensity of liver(SI) at t min after injection(SIt) by precontrast SI(SI0).The total serum bilirubin level(TB),serum albumin level(Alb) and prothrombin time(PT) were recorded.The one-way ANOVA was used to compare the RE among three groups at 5,10 and 20 minutes.SNK was used for further pairwise comparison.The effect of liver function on RE was assessed with the generalized linear model.Pearson correlation coefficients were measured between each biochemical test result(TB,Alb,PT) and RE at different time points.Results The RE at 5,10 and 20 minutes were 1.59±0.20,1.65±0.22,1.69±0.25 of group A; 1.47± 0.14,1.48±0.18,1.50±0.22 of group B,1.35±0.07,1.27±0.06,1.26±0.06 of group C.There were statistically significant differences of RE among groups at 5,10 and 20 minutes(F=5.854,11.207,9.666,P＜0.01).Statistically pairwise comparison differences of RE were found between group A and C at 5,10 and 20 minutes(P＜0.01),between B and C at 10 and 20 minutes(P＜0.05),between A and B at 10 minutes(P＜ 0.05).There were statistically significant differences of TB,Alb and PT among groups(P＜0.01).RE at 10 and 20 minutes had moderate negative correlation with TB(r=-0.483,-0.500; P＜0.01),low negative correlation with PT(r=-0.326,-0.351;P＜0.01) and weak positive correlation with Alb(r=0.290,0.292;P＜0.05).Conclusions There are differences of RE among patients with different liver function,and the RE is associated with TB,Alb and PT.Thus,it may allow us to estimate the liver function.