钆塞酸二钠增强MRI评估全肝及各肝段肝功能

摘要

Objective To investigate the value of gadolinium ethoxybenzyl diethylenetriamine pentaacetic acid (Gd-EOB-DTPA) enhanced MRI in assessing liver reserve function in patients with normal liver function and abnormal liver function.Methods Totally 99 hepatitis B cirrhosis patients with abnormal liver function were classified into the following three groups,i.e.Child-Pugh A group (n=48),Child Pugh B group (n=40),Child Pugh C group (n=11),while 21 patients without chronic liver disease were taken as normal liver function group.All patients underwent Gd-EOB-DTPA enhanced MRI.At 3 min,10 min and 20 min after intravenous administration of Gd-EOB-DTPA,the relative enhancement (RE) of whole liver and liver segments (S1-S8) was calculated,and the differences of liver RE were compared among different liver function groups and liver segments.Results At 3 min,10 min and 20 min after intravenous administration of Gd EOB-DTPA,the differences of whole liver RE and segmental liver RE among the Child Pugh A group,Child-Pugh B group,Child Pugh C group and normal liver function group were statistically different (all P＜0.05).At 3 min,10 min and 20 min after injection,RE of normal liver function group and Child Pugh A group was significantly different among different liver segments (S1-S8).At 10 min and 20 min after injection,RE of Child-Pugh B group was significantly different among different liver segments,while at 20 min after injection,RE of Child-Pugh C group was significantly different among different liver segments.Conclusion Gd-EOB-DTPA enhanced MRI can accurately assess whole liver and segmental liver function.%目的 探讨钆塞酸二钠(Gd-EOB-DTPA)增强MRI评估肝功能正常者及肝功能受损患者肝脏储备功能.方法 将99例乙型肝炎肝硬化肝功能异常者分为Child-Pugh A级(Child-Pugh A级组;n=48)、B级(Child-Pugh B级组;n=40)、C级(Child-PughC级组;n=11),以21例无慢性肝病肝功能正常者为肝功能正常组(n=21).行Gd-EOB-DTPA增强MRI,于注射对比剂后3 min、10 min、20 min图像计算全肝及各肝段相对强化程度(RE),比较不同肝功能分组间、各肝段间(S1～S8)肝脏RE的差异.结果 增强后3 min、10 min、20 min,Child Pugh A级、B级、C级组与肝功能正常组间全肝RE和各肝段RE总体差异均有统计学意义(P均＜0.05).增强后3 min、10 min、20 min,肝功能正常组及Child-Pugh A级组各肝段间RE差异均有统计学意义(P均＜0.05),Child-Pugh B级组增强后10 min、20 min和Child-Pugh C级组增强后20 min各肝段间RE差异有统计学意义(P均＜0.05).结论 Gd EOB-DTPA增强MRI可准确评估全肝及各肝段的功能.