定量分析钆塞酸二钠增强MRI预测肝纤维化和肝硬化病理分级

doi:10.3969/j.issn.2095-9400.2020.09.006

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Abstract Objective: To evaluate and predict histological grades of liver fibrosis and cirrhosis by Gd-EOB-DTPA-enhanced MRI. Methods: Totally 55 patients were recruited in this study, of which 10 cases without liver cirrhosis were divided as the control group, 10 cases with liver fibrosis as the liver fibrosis group, 35 cases with liver cirrhosis as the liver cirrhosis group. Gd-EOB-DTPA-enhanced MRI was performed in all 55 patients before surgery. The signal absolute enhancement value (AEV) and contrast enhancement ratio (CER) was analyzed quantitatively in the unenhancement and hepatobiliary phase of background liver. Then we analyzed the correlation among the signal AEV, the CER and histologic grade of liver fibrosis and cirrhosis. Results: The analysis of the correlation between the signal AEV and the histological grades of different diseased hepatic tissue (r=-0.526, P<0.001) and the correlation between CER and the histological grades of different diseased hepatic tissue (r=-0.741, P<0.001). Between the two analyzed methods of signal intensity, we confirmed the more significant negative correlation between signal CER and the histological grades of different diseased hepatic tissue. The cut-off values calculated by receiver operating characteristic curve (ROC curve) were 0.76 between normal hepatic
tissue and liver fibrosis, 0.46 between liver fibrosis and liver cirrhosis, respectively. Conclusion: The more significant negative correlations between CER and the histological grades of different diseased hepatic tissue were confirmed by quantitative analysis of gadoxetic-acid contrast-enhanced MRI and the analysis of CER can evaluate and predict the histological grades of liver fibrosis and cirrhosis.

Key words： liver cirrhosis Gd-EOB-DTPA MRI histological grade quantitative analysis

Received: 26 September 2019

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	TONG Hongfei
	WANG Zhaohong
	CHEN Hui
	ZHOU Bin
	NI Zhonglin

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https://xb.wmu.edu.cn/EN/10.3969/j.issn.2095-9400.2020.09.006 OR https://xb.wmu.edu.cn/EN/Y2020/V50/I9/717

[1] KIM S U, OH H J, WANLESS I R, et al. The Laennec Staging System for histological subclassification of cirrhosis is useful for stratification of prognosis in patients with liver cirrhosis[J]. J Hepatol, 2012, 57(3): 556-563.
[2] GEISEL D, RAABE P, LÜDEMANN L, et al. Gd-EOB-DTPA-enhanced MRI for monitoring future liver remnant function after portal vein embolization and extended hemihepatectomy: A prospective trial[J]. Eur Radiol, 2017, 27(7): 3080-3087.
[3] KANKI A, TAMADA T, HIGAKI A, et al. Hepatic parenchymal enhancement at Gd-EOB-DTPA-enhanced MR imaging: correlation with morphological grading of severity in cirrhosis and chronic hepatitis[J]. Magn Reson Imaging, 2012, 30(3): 356-360.
[4] BEDOSSA P, POYNARD T. An algorithm for the grading of activity in chronic hepatitis C. The METAVIR Cooperative Study Group[J]. Hepatology, 1996, 24(2): 289-293.
[5] AFDHAL N H, NUNES D. Evaluation of liver fibrosis: a concise review[J]. Am J Gastroenterol, 2004, 99(6): 1160-1174.
[6] DAS S K, VASUDEVAN D M. Genesis of hepatic fibrosis and its biochemical markers[J]. Scand J Clin Lab Invest, 2008, 68(4): 260-269.
[7] FARIA S C, GANESAN K, MWANGI I, et al. MR imaging of liver fibrosis: current state of the art[J]. Radiographics, 2009, 29(6): 1615-1635.
[8] HAIMERL M, VERLOH N, ZEMAN F, et al. Gd-EOB-DTPA-enhanced MRI for evaluation of liver function: comparison between signal-intensity-based indices and T1 relaxometry[J]. Sci Rep, 2017, 7: 43347.
[9] LEE S, CHOI D, JEONG W K. Hepatic enhancement of Gd-EOB-DTPA-enhanced 3Tesla MR imaging: assessing severity of liver cirrhosis[J]. J Magn Reson Imaging, 2016, 44(5): 1339-1345.
[10] MOTOSUGI U, ICHIKAWA T, SOU H, et al. Liver parenchymal enhancement of hepatocyte-phase images in Gd-EOB-DTPA-enhanced MR imaging: which biological markers of the liver function affect the enhancement?[J]. J Magn Reson Imaging, 2009, 30(5): 1042-1046.
[11] HAKO R, KRISTIAN P, JARČUŠKA P, et al. Noninvasive assessment of liver fibrosis in patients with chronic hepatitis B or C by contrast-enhanced magnetic resonance imaging[J]. Can J Gastroenterol Hepatol, 2019, 2019: 3024630.
[12] TAMADA T, ITO K, HIGAKI A, et al. Gd-EOB-DTPA-enhanced MR imaging: evaluation of hepatic enhancement effects in normal and cirrhotic livers[J]. Eur J Radiol, 2011, 80(3): e311-316.
[13] GOSHIMA S, KANEMATSU M, WATANABE H, et al. Gd-EOB-DTPAenhanced MR imaging: prediction of hepatic fibrosis stages using liver contrast enhancement index and liver-to-spleen volumetric ratio[J]. J Magn Reson Imaging, 2012, 36(5): 1148-1153.
[14] NORÉN B, FORSGREN M F, DAHLQVIST LEINHARD O, et al. Separation of advanced from mild hepatic fibrosis by quantification of the hepatobiliary uptake of Gd-EOB-DTPA [J]. Eur Radiol, 2013, 23(1): 174-181.
[15] MA C M, LIU A L, WANG Y Y, et al. The hepatocyte phase of Gd-EOB-DTPA-enhanced MRI in the evaluation of hepatic fibrosis and early liver cirrhosis in a rat model: An experimental study[J]. Life Sci, 2014, 108(2): 104-108