CAJ | 학술논문

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20 min 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。
목적：탐토구새산이납（Gd －EOB －DTPA）특이성증강자공진성상（MRI）평고일반인군간공능적개치。방법사선2013년6월－2014년9월재란주대학제일의원접수1．5T MRI Gd －EOB －DTPA 특이성증강소묘적환자，최종공납입41례만족입조급배제표준적환자，획취기상복부 MRI 평소급 Gd －EOB －DTPA 증강소묘도상급부분림상신식。이비장작위간장신호강도적대조장기，계산평소급주사 Gd －EOB －DTPA 후10、20 min 적간－비신호대비도（SI）、상대간장강화정도（RLE）。계량자료채용독립양본 t 검험혹 Mann －Whitney U 검험，상관분석채용 Spearman 질상관분석。결과주사조영제10、20 min 후적 SI간／비여 Child 분급상관（P ＜0．05），차20 min SI간／비상관도경대（r ＝－0．526，P ＝0．003），이평소 SI간／비여 Child 분급무명현상관성（P ＞0．05）；연지20 min 후적 RLE 야여 Child 분급상관（r ＝－0．362，P ＝0．049），이연지10 min 후적 RLE 여 Child 분급무명현상관성。평소시간경화조화비간경화조환자지간 SI간／비차이무통계학의의（P ＞0．05），이주사조영제10、20 min 후적 SI간／비、RLE20 min차이유통계학의의（P 치균＜0．05）；증강소묘20 min 후적 SI간／비재 ALT 화 TBil 정상조여승고조지간차이도유통계학의의（P 치균＜0．05）。결론Gd －EOB －DTPA 특이성증강소묘능구반영일반인군간공능적변화，우기시주사조영제20 min 후적 SI간／비대평고간공능유중요개치。
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 inclu-sion and exclusion criteria.Taking the spleen as the control organ,liver -spleen signal intensity contrast (SIliver/spleen )and relative liver en-hancement (RLE)were calculated at 10 min and 20 min after injecting Gd -EOB -DTPA.Differences were evaluated using the independ-ent -samples t -test or Mann -Whitney U test.Corrections were analyzed via Spearman’s rank correlation.Results Both SIliver/spleen at 10 min and 20 min after injection of contrast agent were correlated with Child classification (P <0.05).SIliver/spleen at 20 min had a greater correlation coefficient (r =-0.526)than that at 10 min.The SIliver/spleen with plain scan had no significant correlation with Child classifica-tion (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 cir-rhotic and non -cirrhotic groups,SIliver/spleen showed no significant difference (P >0.05).However,SIliver/spleen at 10 min and 20 min,as well as RLE20 min ,showed significant differences between the cirrhotic and non -cirrhotic groups (P <0.05).SIliver/spleen at 20 min also ex-hibited 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/spleen at 20 min may have an important value in assessing the liver function in general population.