Gd-EOB-DTPA增强MRI胆道成像与不同级别肝硬化关系的研究

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 different liver function. Methods A total of 90 patients with and without liver cirrhosis disease (normal liver group,n=30; chronic liver disease group,n=60) were included in our study. All patients were prospectively enrolled for evaluation of known or suspected focal liver lesions. The 90 patients were divided into four groups according to their Child-Pugh classification: normal liver function (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 common bile duct (CBD) (RSI=SICBD/mean SI erect spinae muscle) and the RSI of liver parenchyma were measured and calculated in the same way. RSI of CBD and RSI of liver parenchyma were entered into regression analysis. Results The mean RSI of liver parenchyma 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. The average 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,respectively. CE-MRC images of NLF and LCA were significantly better than those of LCB and LCC in terms of both visualization ratings and RSI of CBD. Conclusion The results of our study demonstrate that Gd-EOB-DTPA enhanced MRI can accurately evaluate liver function quantitatively,and different liver function significantly affects biliary system visualization in Gd-EOB-DTPA enhanced CE-MRC.