中华肝胆外科杂志
中華肝膽外科雜誌
중화간담외과잡지
CHINESE JOURNAL OF HEPATOBILIARY SURGERY
2014年
8期
553-556
,共4页
肝功能%钆塞酸二钠%磁共振成像
肝功能%釓塞痠二鈉%磁共振成像
간공능%구새산이납%자공진성상
Liver function%Gadolinium ethoxybenzyl diethylenetriamine pentaacetic acid (Gd-EOB-DTPA)%Magnetic resonance imaging (MRI)
目的 探讨采用钆塞酸二钠(Gd-EOB-DTPA)增强MRI肝胆期肝脏强化程度评估肝功能的方法.方法 回顾性分析55例行MRI平扫及注射Gd-EOB-DTPA后延迟5、10和20 min肝胆期成像的患者资料.根据肝功能将患者分为两组(组1:正常肝脏及Child-Pugh评分A级者,35例;组2:Child-Pugh评分B级和C级者,20例),测量各时间点肝脏相对强化程度(RE),记录一般资料(年龄、性别)和相关实验室检查结果.独立样本t检验比较2组间肝胆期各时间点RE,受试者工作特征(ROC)曲线确定反映2组RE差异的最佳时间点及RE临界值,回归分析所有患者最佳时间点RE与实验室检查结果间的关系,多元逐步回归筛选影响最佳时间点RE的独立因素.结果 2组间肝胆期各时间点RE的差异均有统计学意义(P值均＜0.0001).10 min是反映2组肝功能差异的最佳时间点.当RE＞1.52时,判断为正常肝脏或Child-Pugh评分A级的敏感度为74.3％,特异性为90％.最佳时间点RE与TBil、Alb及PT明显相关,且TBil为独立影响因素.结论 RE可用于肝功能评估,且延迟10 min为区分正常或轻度肝损伤与中重度肝损伤的最佳时间点,TBil为RE的独立影响因素.
目的 探討採用釓塞痠二鈉(Gd-EOB-DTPA)增彊MRI肝膽期肝髒彊化程度評估肝功能的方法.方法 迴顧性分析55例行MRI平掃及註射Gd-EOB-DTPA後延遲5、10和20 min肝膽期成像的患者資料.根據肝功能將患者分為兩組(組1:正常肝髒及Child-Pugh評分A級者,35例;組2:Child-Pugh評分B級和C級者,20例),測量各時間點肝髒相對彊化程度(RE),記錄一般資料(年齡、性彆)和相關實驗室檢查結果.獨立樣本t檢驗比較2組間肝膽期各時間點RE,受試者工作特徵(ROC)麯線確定反映2組RE差異的最佳時間點及RE臨界值,迴歸分析所有患者最佳時間點RE與實驗室檢查結果間的關繫,多元逐步迴歸篩選影響最佳時間點RE的獨立因素.結果 2組間肝膽期各時間點RE的差異均有統計學意義(P值均＜0.0001).10 min是反映2組肝功能差異的最佳時間點.噹RE＞1.52時,判斷為正常肝髒或Child-Pugh評分A級的敏感度為74.3％,特異性為90％.最佳時間點RE與TBil、Alb及PT明顯相關,且TBil為獨立影響因素.結論 RE可用于肝功能評估,且延遲10 min為區分正常或輕度肝損傷與中重度肝損傷的最佳時間點,TBil為RE的獨立影響因素.
목적 탐토채용구새산이납(Gd-EOB-DTPA)증강MRI간담기간장강화정도평고간공능적방법.방법 회고성분석55례행MRI평소급주사Gd-EOB-DTPA후연지5、10화20 min간담기성상적환자자료.근거간공능장환자분위량조(조1:정상간장급Child-Pugh평분A급자,35례;조2:Child-Pugh평분B급화C급자,20례),측량각시간점간장상대강화정도(RE),기록일반자료(년령、성별)화상관실험실검사결과.독립양본t검험비교2조간간담기각시간점RE,수시자공작특정(ROC)곡선학정반영2조RE차이적최가시간점급RE림계치,회귀분석소유환자최가시간점RE여실험실검사결과간적관계,다원축보회귀사선영향최가시간점RE적독립인소.결과 2조간간담기각시간점RE적차이균유통계학의의(P치균＜0.0001).10 min시반영2조간공능차이적최가시간점.당RE＞1.52시,판단위정상간장혹Child-Pugh평분A급적민감도위74.3％,특이성위90％.최가시간점RE여TBil、Alb급PT명현상관,차TBil위독립영향인소.결론 RE가용우간공능평고,차연지10 min위구분정상혹경도간손상여중중도간손상적최가시간점,TBil위RE적독립영향인소.
Objective To investigate the utilization of liver enhancement in hepatobiliary phase of gadolinium ethoxybenzyl diethylenetriamine pentaacetic acid (Gd-EOB-DTPA)-enhanced MRI for liver function evaluation.Methods Fifty-five patients who received enhanced MRI with Gd-EOB-DTPA were retrospectively analyzed.Images were obtained before injection and in hepatobiliary phase (5,10,and 20 minutes after Gd-EOB-DTPA injection).The patients were assigned into two subgroups according to individual liver function (n =35 in Group 1:normal liver and Child-Pugh class A; n =20 in Group 2:Child-Pugh class B and C).The relative liver enhancement (RE) was calculated at different time point.The general data (age,sex) and relevant laboratory results were recorded.Independent sample t-test was conducted to compare the RE between two groups at different time point.ROC curve was used to determine the best time point and RE threshold that can reflect the differences between two groups.Univariate analyses was performed to analyze the relationship between RE at the best time point and laboratory results.Multivariate analyses was performed to screen the independent influencing factor for RE at the best time point.Results The differences of RE between two groups were statistically significant at all time points (P ＜ 0.0001).10 minutes was the best time point for detecting the differences of liver function between two groups.When an RE cutoff value (＞ 1.52) was applied,normal or Child-Pugh class A could be predicted with sensitivity of 74.3％ and specificity of 90％.RE at the best time point was significantly related with total serum bilirubin level (TBil),serum albumin level (Alb) and prothrombin time (PT).And TBil was an independent influencing factor.Conclusion RE can be used to evaluate the liver function,and 10 minutes is the best time point that can be used to differentiate patients with normal or mild liver damage from those with moderate or severe liver damage.
