Gd-EOB-DTPA增强MRI胆道成像与不同级别肝硬化关系的研究
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摘要
目的通过对肝硬化与肝功能正常者行Gd-EOB-DTPA增强MR胆道成像(CE-MRC)效果进行对比研究,并探讨肝功能对胆管显像的影响。方法回顾性分析90例肝硬化和正常组(正常组30例;肝硬化组60例)分别行Gd-EOB-DTPA增强MR胆道成像,90例患者根据Child-Pugh分级分为4组:正常组(NLF):30例; Child-Pugh A (LCA):30例; Child-Pugh B (LCB):19例; Child-Pugh C (LCC):11例。测量并计算出相对胆总管信号强度(relative signal intensity,RSI胆总管=SI胆总管/SI竖脊肌)和相对肝信号强度(RSI肝=SI肝/SI竖脊肌),并对RSI胆总管与RSI肝进行相关回归分析。结果正常组,LCA,LCB,LCC组RSI肝值分别为0. 62±0. 06,0. 56±0. 02,0. 40±0. 05,和0. 29±0. 02,注射Gd-EOB-DTPA 20min后4组RSI胆总管分别为18. 04±0. 29,17. 12±0. 41,3. 95±0. 63和3. 33±0. 30。NLF组和LCA组胆管显影效果及RSI胆总管均高于LCB组和LCC组。结论 Gd-EOB-DTPA增强MR胆道成像能有效评估肝功能,不同的肝功能会影响Gd-EOB-DTPA增强MR胆道成像效果。
Objective To assess the effect of liver function on biliary tract visualization using gadolinium ethoxybenzyl diethylenetriamine pentaacetic acid( Gd-EOB-DTPA)-enhanced magnetic resonance cholangiography( CE-MRC) in patients with differ-ent liver function. Methods A total of 90 patients with and without liver cirrhosis disease( normal liver group,n = 30; chronicliver disease group,n = 60) were included in our study. All patients were prospectively enrolled for evaluation of known or sus-pected focal liver lesions. The 90 patients were divided into four groups according to their Child-Pugh classification: normal liverfunction( NLF) group( n = 30); liver cirrhosis with Child-Pugh A( LCA) group( n = 30); liver cirrhosis with Child-Pugh B( LCB) group( n = 19) and liver cirrhosis with Child-Pugh C( LCC) group( n = 11). Relative signal intensity( RSI) of commonbile duct( CBD)( RSI = SICBD/mean SI erect spinae muscle) and the RSI of liver parenchyma were measured and calculated inthe same way. RSI of CBD and RSI of liver parenchyma were entered into regression analysis. Results The mean RSI of liverparenchyma of NLF and LCA to LCC groups were 0. 62 ± 0. 06,0. 56 ± 0. 02,0. 40 ± 0. 05,and 0. 29 ± 0. 02,respectively. Theaverage RSI of CBD for the four groups of patients 20 min was 18. 04 ± 0. 29,17. 12 ± 0. 41,3. 95 ± 0. 63,and 3. 33 ± 0. 30,re-spectively. CE-MRC images of NLF and LCA were significantly better than those of LCB and LCC in terms of both visualizationratings and RSI of CBD. Conclusion The results of our study demonstrate that Gd-EOB-DTPA enhanced MRI can accurately e-valuate liver function quantitatively,and different liver function significantly affects biliary system visualization in Gd-EOB-DTPA enhanced CE-MRC.
Objective To assess the effect of liver function on biliary tract visualization using gadolinium ethoxybenzyl diethylenetriamine pentaacetic acid( Gd-EOB-DTPA)-enhanced magnetic resonance cholangiography( CE-MRC) in patients with differ-ent liver function. Methods A total of 90 patients with and without liver cirrhosis disease( normal liver group,n = 30; chronicliver disease group,n = 60) were included in our study. All patients were prospectively enrolled for evaluation of known or sus-pected focal liver lesions. The 90 patients were divided into four groups according to their Child-Pugh classification: normal liverfunction( NLF) group( n = 30); liver cirrhosis with Child-Pugh A( LCA) group( n = 30); liver cirrhosis with Child-Pugh B( LCB) group( n = 19) and liver cirrhosis with Child-Pugh C( LCC) group( n = 11). Relative signal intensity( RSI) of commonbile duct( CBD)( RSI = SICBD/mean SI erect spinae muscle) and the RSI of liver parenchyma were measured and calculated inthe same way. RSI of CBD and RSI of liver parenchyma were entered into regression analysis. Results The mean RSI of liverparenchyma of NLF and LCA to LCC groups were 0. 62 ± 0. 06,0. 56 ± 0. 02,0. 40 ± 0. 05,and 0. 29 ± 0. 02,respectively. Theaverage RSI of CBD for the four groups of patients 20 min was 18. 04 ± 0. 29,17. 12 ± 0. 41,3. 95 ± 0. 63,and 3. 33 ± 0. 30,re-spectively. CE-MRC images of NLF and LCA were significantly better than those of LCB and LCC in terms of both visualizationratings and RSI of CBD. Conclusion The results of our study demonstrate that Gd-EOB-DTPA enhanced MRI can accurately e-valuate liver function quantitatively,and different liver function significantly affects biliary system visualization in Gd-EOB-DTPA enhanced CE-MRC.
引文
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[4] Takaoa H,Tajima T,Kiryu S,et al. MR imaging of the biliarytract with Gd-EOB-DTPA:effect of liver function on signal inten-sity[J]. European Journal of Radiology,2011,77(2):325-329.
[5] Hamm B,Staks T,Mühler A,et al. Phase I clinical evaluation ofGd-EOB-DTPA as a hepatobiliary MR contrast agent:safety,pharmacokinetics,and MR imaging[J]. Radiology,1995,195(3):785-792.
[6] Bollow M,Taupitz M,Hamm B,et al. Gadolinium-ethoxybenzyl-DTPA as a hepatobiliary contrast agent for use in MR cholangiog-raphy:results of an in vivo phase-I clinical evaluation[J]. Euro-pean Radiology,1997,7(1):126-132.
[7] Vogl TJ,Kümmel S,Hammerstingl R,et al. Liver tumors:com-parison of MR imaging with Gd-EOB-DTPA and Gd-DTPA[J].Radiology,1996,200(1):59-67.
[8] Parente DB,Perez RM,Eirasaraujo A,et al. MR imaging of hy-pervascular lesions in the cirrhotic liver:a diagnostic dilemma[J]. Radiographics,2012,32(3):767-787.
[9] Bollow M,Taupitz M,Hamm B,et al. Gadolinium-ethoxybenzyl-DTPA as a hepatobiliary contrast agent for use in MR cholangiog-raphy:results of an in vivo phase-I clinical evaluation[J]. Euro-pean Radiology,1997,7(1):126-132.
[10] Tschirch FT,Struwe A,Petrowsky H,et al. Contrast-enhancedMR cholangiography with Gd-EOB-DTPA in patients with livercirrhosis:visualization of the biliary ducts in comparison with pa-tients with normal liver parenchyma[J]. European Radiology,2008,18(8):1577-1586.
[11] Salvolini L,Urbinati C,Valeri G,et al. Contrast-enhanced MRcholangiography(MRCP)with GD-EOB-DTPA in evaluating bil-iary complications after surgery[J]. La Radiologia Medica,2012,117(3):354-368.
[12] Feng ST,Wu L,Chan T,et al. Functional magnetic resonancecholangiography enhanced with Gd-EOB-DTPA:effect of liverfunction on biliary system visualization[J]. Journal of MagneticResonance Imaging Jmri,2014,39(5):1254-1258.
[13] Hamm B,Staks T,Mühler A,et al. Phase I clinical evaluationof Gd-EOB-DTPA as a hepatobiliary MR contrast agent:safety,pharmacokinetics,and MR imaging[J]. Radiology,1995,195(3):785-792.
[2] Papanikolaou N,Prassopoulos P,Eracleous E,et al. Contrast-enhanced magnetic resonance cholangiography versus heavily T2-weighted magnetic resonance cholangiography[J]. InvestigativeRadiology,2001,36(11):682-687.
[3] Motosugi U,Ichikawa T,Sou H,et al. Liver parenchymal en-hancement of hepatocyte-phase images in Gd-EOB-DTPA-en-hanced MR imaging:which biological markers of the liver func-tion affect the enhancement?[J]. J Magn Reson Imaging,2009,30(5):1042-1046.
[4] Takaoa H,Tajima T,Kiryu S,et al. MR imaging of the biliarytract with Gd-EOB-DTPA:effect of liver function on signal inten-sity[J]. European Journal of Radiology,2011,77(2):325-329.
[5] Hamm B,Staks T,Mühler A,et al. Phase I clinical evaluation ofGd-EOB-DTPA as a hepatobiliary MR contrast agent:safety,pharmacokinetics,and MR imaging[J]. Radiology,1995,195(3):785-792.
[6] Bollow M,Taupitz M,Hamm B,et al. Gadolinium-ethoxybenzyl-DTPA as a hepatobiliary contrast agent for use in MR cholangiog-raphy:results of an in vivo phase-I clinical evaluation[J]. Euro-pean Radiology,1997,7(1):126-132.
[7] Vogl TJ,Kümmel S,Hammerstingl R,et al. Liver tumors:com-parison of MR imaging with Gd-EOB-DTPA and Gd-DTPA[J].Radiology,1996,200(1):59-67.
[8] Parente DB,Perez RM,Eirasaraujo A,et al. MR imaging of hy-pervascular lesions in the cirrhotic liver:a diagnostic dilemma[J]. Radiographics,2012,32(3):767-787.
[9] Bollow M,Taupitz M,Hamm B,et al. Gadolinium-ethoxybenzyl-DTPA as a hepatobiliary contrast agent for use in MR cholangiog-raphy:results of an in vivo phase-I clinical evaluation[J]. Euro-pean Radiology,1997,7(1):126-132.
[10] Tschirch FT,Struwe A,Petrowsky H,et al. Contrast-enhancedMR cholangiography with Gd-EOB-DTPA in patients with livercirrhosis:visualization of the biliary ducts in comparison with pa-tients with normal liver parenchyma[J]. European Radiology,2008,18(8):1577-1586.
[11] Salvolini L,Urbinati C,Valeri G,et al. Contrast-enhanced MRcholangiography(MRCP)with GD-EOB-DTPA in evaluating bil-iary complications after surgery[J]. La Radiologia Medica,2012,117(3):354-368.
[12] Feng ST,Wu L,Chan T,et al. Functional magnetic resonancecholangiography enhanced with Gd-EOB-DTPA:effect of liverfunction on biliary system visualization[J]. Journal of MagneticResonance Imaging Jmri,2014,39(5):1254-1258.
[13] Hamm B,Staks T,Mühler A,et al. Phase I clinical evaluationof Gd-EOB-DTPA as a hepatobiliary MR contrast agent:safety,pharmacokinetics,and MR imaging[J]. Radiology,1995,195(3):785-792.