CAJ | 학술논문

目的研究钆塞酸二钠(Gd-EOB-DTPA)增强MRI在肝脏功能定量评估中的临床价值.方法前瞻性纳入2012年6月至2013年6月收治的8例肝硬化和6例原发性肝癌患者.所有患者均于术前和术后进行Child-Pugh分级.术前测定吲哚菁绿15 min储留率(ICGR15);并行肝脏Gd-EOB-DTPA增强MRI扫描,获得感兴趣区(ROI)和主动脉区的时间-强度曲线,再利用反卷积方法计算肝脏摄取分数(HEF).分析HEF与ICGR15的相关性以及术前、术后Child-Pugh分级变化与HEF的关系.结果单纯肝硬化患者平均HEF[(80.51±7.77)％]与ICGR15[(13.99±7.65)％]高度相关(r=-0.971,P＜0.05).原发性肝癌组平均HEF[(87.01±8.10)％]与平均ICGR15[(9.67±4.60)％]也呈高度相关(r=-0.855,P＜0.05).术前HEF值越低,术后发生肝脏功能衰竭的可能性越大.肝癌肿瘤区HEF 14.89％～ 35.90％,平均为21.80％.结论钆塞酸二钠增强MRI能准确定量评估肝脏储备功能,可应用于原发性肝癌患者术前检查.
목적 연구구새산이납(Gd-EOB-DTPA)증강MRI재간장공능정량평고중적림상개치.방법 전첨성납입2012년6월지2013년6월수치적8례간경화화6례원발성간암환자.소유환자균우술전화술후진행Child-Pugh분급.술전측정신타정록15 min저류솔(ICGR15);병행간장Gd-EOB-DTPA증강MRI소묘,획득감흥취구(ROI)화주동맥구적시간-강도곡선,재이용반권적방법계산간장섭취분수(HEF).분석HEF여ICGR15적상관성이급술전、술후Child-Pugh분급변화여HEF적관계.결과 단순간경화환자평균HEF[(80.51±7.77)％]여ICGR15[(13.99±7.65)％]고도상관(r=-0.971,P＜0.05).원발성간암조평균HEF[(87.01±8.10)％]여평균ICGR15[(9.67±4.60)％]야정고도상관(r=-0.855,P＜0.05).술전HEF치월저,술후발생간장공능쇠갈적가능성월대.간암종류구HEF 14.89％～ 35.90％,평균위21.80％.결론 구새산이납증강MRI능준학정량평고간장저비공능,가응용우원발성간암환자술전검사.
Objective To explore the value of Gd-EOB-DTPA enhanced magnetic resonance imaging (MRI) in the quantitative evaluation of liver function.Methods Between June 2012 and June 2013,we prospectively included 8 patients with cirrhosis and 6 patients with primary hepatic carcinoma (PHC).The Child-Pugh classification,indocyanine green retention rate at 15 minutes (ICGR15),and Primovist enhanced MR imaging were performed in all the patients.Using the deconvolution method to calculate hepatic extraction fraction (HEF),the correlations between HEF and Child-Pugh and ICGR15 were analyzed.Results For cirrhosis,there was a significant correlation between the HEF and the ICGR15 by the Pearson correlation coefficient (r =-0.971,P ＜ 0.05).For hepatocarcinoma,there was also a significant correlation (r =-0.855,P ＜ 0.05).The average HEF of PHC was 21.80％ (14.89％～ 35.90％).Conclusions The Gd-EOB-DTPA enhanced MRI accurately evaluated liver function quantitatively.It may be used for patients with PHC for preoperative examination.