Efficacy of liver parenchymal enhancement and liver volume to standard liver volume ratio on Gd-EOB-DTPA-enhanced MRI for estimation of liver function

Objective

We aimed to develop and assess the efficacy of a liver function index that combines liver enhancement and liver volume to standard liver volume (LV/SLV) ratio on gadolinium ethoxybenzyl diethylenetriaminepentaacetic acid (Gd-EOB-DTPA)-enhanced MRI.

Methods

In all, 111 patients underwent a Gd-EOB-DTPA-enhanced MRI, including T1 mapping, before and 20 min after Gd-EOB-DTPA administration. We calculated the following Gd-EOB-DTPA-enhanced MRI-based liver function indices: relative enhancement of the liver, corrected enhancement of the liver-to-spleen ratio, LSC_N20, increase rate of the liver-to-muscle ratio, reduction rate of T1 relaxation time of the liver, ΔR1 of the liver and K _Hep; the indices were multiplied by the LV/SLV ratio. We calculated the correlations between an indocyanine green (ICG) clearance and the Gd-EOB-DTPA-enhanced MRI-based liver function indices multiplied by the LV/SLV ratio, by using Pearson correlation analysis.

Results

There were significant correlations between all Gd-EOB-DTPA-enhanced MRI-based liver function indices and ICG clearance (r?=??0.354 to ?0.574, P?<?0.001). All Gd-EOB-DTPA-enhanced MRI-based liver function indices multiplied by the LV/SLV ratio (r?=??0.394 to ?0.700, P?<?0.001) were more strongly correlated with the ICG clearance than those without multiplication by the LV/SLV ratio.

Conclusions

Gd-EOB-DTPA-enhanced MRI-based liver function indices that combine liver enhancement and the LV/SLV ratio may more reliably estimate liver function.

Key points

? Gd-EOB-DTPA-enhanced MRI is useful for assessing liver function. ? Liver enhancement on Gd-EOB-DTPA-enhanced MRI correlates with indocyanine green (ICG) clearance. ? Liver volume to standard liver volume (LV/SLV) ratio correlates with ICG clearance. ? Liver enhancement and LV/SLV ratio help to estimate liver function.     

Multiparametric MRI combined with liver volume for quantitative evaluation of liver function in patients with cirrhosis

PURPOSEWe aimed to establish a liver function evaluation model by combining multiparametric magnetic resonance imaging (MRI) with liver volume (LV) and further verify the effectiveness of the model to evaluate liver function.METHODSThis retrospective study included 101 consecutive cirrhosis patients (69 cases for modeling group and 32 cases for validation group) who underwent gadoxetic acid-enhanced MRI. Five signal intensity parameters were obtained by measuring the signal intensities of the liver, spleen, and erector spinae before and 20 minutes after gadoxetic acid disodium enhancement. The diffusion coefficient (D), pseudo-diffusion coefficient (D*), and perfusion fraction (f) were obtained from intravoxel incoherent motion diffusion-weighted imaging. The LV parameters (V_liver, V_spleen, and V_liver/V_spleen) were obtained using 3-dimensional image generation software. The most effective parameter was selected from each of the 3 methods, and a multivariate regression model for liver function evaluation was established and validated.RESULTSIn the modeling group, relative enhancement (RE), D*, and V_liver/V_spleen showed significant differences among the different liver function groups (P < .001). Receiver operating characteristic analysis showed that these parameters had the highest area under the curve (AUC) values for distinguishing Child-Pugh A from Child-Pugh B and C groups (0.917, 0.929, and 0.885, respectively). The following liver function model was obtained by multivariate regression analysis: F(x) = 3.96 − 1.243 (RE) − 0.034 (D*) − 0.080 (V_liver/V_spleen) (R² = 0.811, P < .001). In the patients with cirrhosis, the F(x) of Child-Pugh A, B, and C were 1.16 ± 0.44, 1.95 ± 0.29, and 2.79 ± 0.38, respectively. In the validation group, the AUC for F(x) to distinguish Child-Pugh A from Child-Pugh B and C was 0.973.CONCLUSIONCombining multiparametric MRI with LV effectively distinguished patients with different Child-Pugh grades. This model could hence be useful as a novel radiological marker to estimate the liver function.

Main points

• Among the parameters generated by gadoxetic acid disodium-enhanced magnetic resonance imaging (MRI), intravoxel incoherent motion, and liver volume, the relative enhancement (RE), pseudo-diffusion coefficient (D*), and liver-spleen volume ratio (V_liver/V_spleen) displayed the best liver function classification performance.
• The model F(x) combining multiparametric MRI with liver volume showed an area under the curve of 0.973 in distinguishing Child-Pugh A from Child-Pugh B and C. The sensitivity and specificity were 97.6% and 90.9%, respectively.
• The model integrates the functional and morphological information of the liver. It is useful for quantitative liver function evaluation and is expected to be used for preoperative liver function evaluation.

Liver cirrhosis is a pathological stage characterized by diffuse fibrosis of the liver, formation of pseudo-lobules, and blood vessel proliferation in the liver.¹ Liver function assessment is the main factor affecting the prognosis of patients with liver cirrhosis, and the assessment of preoperative and residual liver function is extremely important for patients with liver cancer.² Moreover, liver function is unevenly distributed in the liver parenchyma and varies between different lobes and segments in cirrhosis.³ The liver morphology changes in different stages of cirrhosis. This change is partly derived from changes in the volume and number of liver parenchymal cells. However, clinical methods for assessing liver function focused on clinical symptoms, biochemical blood parameters, and lack of evaluation of liver morphology.^4-6Magnetic resonance imaging (MRI) can provide morphological and functional information about the liver. Gadoxetic acid disodium (Gd-EOB-DTPA) is a liver-targeting MRI contrast agent which can be specifically ingested by normal hepatocytes.⁷ Images of hepatobiliary phase could accurately assess liver volume (LV) which is another important clinical index for liver function.⁸ Liver function is impaired and the number of hepatocytes with normal Gd-EOB-DTPA uptake is reduced in cirrhosis. At the same time, the uptake of Gd-EOB-DTPA by hepatocytes is reduced due to the proliferation of fibrous stroma and the reduction of organic anion transporter polypeptide (OATP) expression. Consequently, the liver signal decreases during the hepatobiliary phase.⁹ During the progression of cirrhosis, the increased intrahepatic connective tissue reduces hepatic blood flow and diffusion capacity, leading to hepatocyte degeneration, inflammatory infiltration, and fibrosis. All of this leads to changes in liver tissue structure and perfusion. Intravoxel incoherent motion diffusion-weighted imaging (IVIM-DWI) can simultaneously obtain information on liver perfusion and water diffusion. The diffusion coefficient (D) value has high sensitivity and specificity in detecting liver fibrosis.¹⁰ Multiparametric imaging combining conventional techniques could enable a comprehensive examination of the liver.¹¹In view of the potential value of LV and multiparametric MRI in liver function assessment, this study aims to establish a liver function evaluation model by combining multiparametric MRI with LV and further verify the effectiveness of the model to evaluate liver function.     

Assessing liver function by liver enhancement during the hepatobiliary phase with Gd-EOB-DTPA-enhanced MRI at 3 Tesla

Objectives

The purpose of this study was to evaluate the usefulness of Gd-EOB-DTPA-enhanced 3-T MRI to determine the hepatic functional reserve expressed by the model for end-stage liver disease (MELD) score.

Methods

A total of 121 patients with normal liver function (NLF; MELD score?≤?10) and 29 patients with impaired liver function (ILF; MELD score?>?10) underwent contrast-enhanced MRI with a hepatocyte-specific contrast agent at 3T. T1-weighted volume interpolated breath-hold examination (VIBE) sequences with fat suppression were acquired before and 20 min after contrast injection. Relative enhancement (RE) between plain signal intensity and contrast-enhanced signal intensity was calculated and was used to determine Gd-EOB-DTPA uptake into the liver parenchyma for patients with different MELD scores.

Results

RE differed significantly (p?≤?0.001) between patients with NLF (87.2?±?29.5 %) and patients with ILF (45.4?±?26.5 %). The optimal cut-off value for RE to differentiate NLF from ILF was 47.7 % (AUC 0.87). This cut-off value showed a sensitivity of 82.8 % and a specificity of 92.7 % for the differentiation of the analysed groups.

Conclusion

Gd-EOB-DTPA uptake in hepatocytes is strongly affected by liver function. Gd-EOB-DTPA-enhanced MRI and assessment of RE during the hepatobiliary phase (HBP) may serve as a useful image-based test in liver imaging for determining regional and global liver function.

Key points

• Hepatic uptake of Gd-EOB-DTPA is strongly affected by liver function.
• Relative enhancement during HBP in GD-EOB-DTPA MRI correlates with the MELD score.
• Assessment of relative enhancement may help improve treatment in routine clinical practice.

     

Combining diffusion-weighted MRI with Gd-EOB-DTPA-enhanced MRI improves the detection of colorectal liver metastases

Objectives

To compare the diagnostic accuracy of gadolinium-ethoxybenzyl-diethylenetriaminepentaacetic acid (Gd-EOB-DTPA)-enhanced MRI, diffusion-weighted MRI (DW-MRI) and a combination of both techniques for the detection of colorectal hepatic metastases.

Methods

72 patients with suspected colorectal liver metastases underwent Gd-EOB-DTPA MRI and DW-MRI. Images were retrospectively reviewed with unenhanced T₁ and T₂ weighted images as Gd-EOB-DTPA image set, DW-MRI image set and combined image set by two independent radiologists. Each lesion detected was scored for size, location and likelihood of metastasis, and compared with surgery and follow-up imaging. Diagnostic accuracy was compared using receiver operating characteristics and interobserver agreement by kappa statistics.

Results

417 lesions (310 metastases, 107 benign) were found in 72 patients. For both readers, diagnostic accuracy using the combined image set was higher [area under the curve (Az) = 0.96, 0.97] than Gd-EOB-DTPA image set (Az = 0.86, 0.89) or DW-MRI image set (Az = 0.93, 0.92). Using combined image set improved identification of liver metastases compared with Gd-EOB-DTPA image set (p<0.001) or DW-MRI image set (p<0.001). There was very good interobserver agreement for lesion classification (κ = 0.81–0.88).

Conclusions

Combining DW-MRI with Gd-EOB-DTPA-enhanced T₁ weighted MRI significantly improved the detection of colorectal liver metastases.In patients with colorectal cancer, accurate assessment of the size, location and segmental distribution of liver metastases on a per-lesion basis is critical for treatment planning [1]. Accurate depiction of the size and distribution of liver metastases helps the selection of patients to undergo radical surgery [2,3] or minimally invasive therapy, such as radiofrequency ablation (RFA) [4], chemo-embolisation or radio-embolisation [5].The image contrast in diffusion-weighted MRI (DW-MRI) is based on differences in the mobility of water between tissues [6]. In tumour tissues, such as liver metastases, water mobility is often more impeded compared with normal parenchyma. Hence, metastases appear to have high signal intensity on DW-MRI, facilitating their detection.Compared with conventional T₂ weighted imaging, DW-MRI has been found to be superior for lesion detection in the liver [7-9]. When compared with contrast-enhanced MRI, DW-MRI had a higher diagnostic accuracy compared with superparamagnetic iron oxide (SPIO)-enhanced MRI [10] and similar diagnostic accuracy compared with gadolinium contrast-enhanced imaging [11] for detecting colorectal liver metastases. DW-MRI has also been found to be more sensitive than fluorodeoxyglucose (¹⁸FDG) positron emission tomography (PET) CT [12] for the same clinical indication. In another study, combining DW-MRI with T₁ weighted imaging after liver-specific contrast medium mangafodipir trisodium (MnDPDP) administration improved the diagnostic accuracy of colorectal liver metastases detection compared with either technique alone [13].Gadolinium-ethoxybenzyl-diethylenetriaminepentaacetic acid (Gd-EOB-DTPA; Eovist or Primovist; Bayer Schering Pharma, Berlin, Germany) is a relatively new hepatocyte-selective MR contrast medium that has been shown to be useful detecting liver metastases measuring <1 cm in diameter [14,15]. Delayed T₁ weighted imaging in the hepatocellular phase of contrast enhancement at 20 min to several hours after contrast administration demonstrates metastases as T₁ hypointense lesions against the avidly enhancing liver parenchyma.Both DW-MRI and Gd-EOB-DTPA-enhanced MRI are useful for the detection of liver metastases [7,8,14-16]. One study performed at 3 T compared the diagnostic performance of the two techniques for the identification of small (<2 cm) liver metastases [17]. Another study at 1.5 T independently compared the diagnostic performance of DW-MRI, dynamic phase MRI and hepatobiliary phase Gd-EOB-DTPA-enhanced MRI [18]. However, the possible incremental value of combining DW-MRI with Gd-EOB-DTPA-enhanced MRI for detecting colorectal metastases has not been reported. Hence, the aim of this study was to compare the diagnostic accuracy of Gd-EOB-DTPA-enhanced MRI, DW-MRI and a combination of both techniques for the detection of colorectal hepatic metastases.     

Three-dimensional images of liver tumours reconstructed by Gd-EOB-DTPA-enhanced MRI

The purpose of this study was to evaluate three-dimensional images of liver tumours obtained with gadolinium ethoxybenzyl diethylenetriamine penta-acetic acid (Gd-EOB-DTPA)-enhanced MRI (3D-EOB-MRI) in hepatic surgery. We conclude that 3D-EOB-MRI may be an alternative method for depicting liver tumours adjacent to the hepatic veins and portal branches, and may provide additional information for surgical planning.     

钆塞酸二钠增强MRI肝细胞摄取定量参数评估肝功能

目的:探讨钆塞酸二钠(Gd-EOB-DTPA)增强MR扫描中肝细胞分数对肝功能的定量评估价值.方法:2017年8月-2019年1月前瞻性将69例乙型肝炎合并肝硬化的患者纳入本研究.其中肝功能为Child-Pugh A级46例(LCA),Child-Pugh B级(LCB)21例,Child-Pugh C级(LCC)2例...     

New proposal for the staging of nonalcoholic steatohepatitis: Evaluation of liver fibrosis on Gd-EOB-DTPA-enhanced MRI

Purpose

We investigated whether the gadolinium-ethoxybenzyl-diethylenetriamine pentaacetic acid (Gd-EOB-DTPA)-enhanced MRI was useful for nonalcoholic steatohepatitis (NASH) staging based on the severity of liver fibrosis.

Materials and methods

Twenty-one male Sprague-Dawley rats aged 7 weeks, weighing about 150 g in NASH group were fed a choline-deficient diet for 4, 7 or 10 weeks, and seven rats in the control group were fed a standard diet (n = 7). After the feeding period, the rats were subjected to contrast-enhanced MRI (2D-FLASH; TR/TE = 101/2.9 ms, flip angle 90°). Gd-DTPA (0.1 mmol Gd/kg) and Gd-EOB-DTPA (0.025 mmol Gd/kg) were injected at 24-h intervals, and the speed of contrast injection was 1 mL/s. Signal intensities of the liver were measured and the relative enhancement (RE), the time of maximum RE (T_max) and elimination half-life of RE (T_1/2) in the liver were compared. The fibrosis rate (%) was calculated with the following formula: fibrosis/whole area × 100.

Results

The fibrosis rates of each group were as follows: 0.52, 0.79, 2.84, and 0.50% (4, 7, 10 weeks and control groups). The fibrosis rate of the 10 weeks group was significantly higher than the control and 4 or 7 weeks groups. Although there was no difference between the T_max and T_1/2 of each group after Gd-DTPA injection, the T_max and T_1/2 of the 10 weeks group were significantly prolonged in comparison with the control and 4 or 7 weeks groups after Gd-EOB-DTPA injection (p < 0.01). There was a significant correlation between the fibrosis rate and T_max or T_1/2 after Gd-EOB-DTPA injection (r = 0.90 or 0.97).

Conclusion

It was possible to assess the progress of liver fibrosis in NASH by evaluating the signal intensity-time course on Gd-EOB-DTPA-enhanced MRI.     

Gd-EOB-DTPA增强MRI对Oddi括约肌及胆囊管功能的动态评估

目的:探讨正常志愿者行Gd-EOB-DTPA动态增强MRI中,Gd-EOB-DTPA在十二指肠内及胆囊内显影的时间,为胆道系统功能障碍疾病的诊断提供依据.方法:前瞻性纳入30例行Gd-EOB-DTPA MRI增强扫描的志愿者,于注射对比剂后第5～90 min内连续动态扫描.扫描时间点分别为第5～30 min内每间隔1 min、第30～60min内每间隔5 min、第60～90 min内每间隔10 min采集一次图像.由2位放射科医生对图像进行共同评估,记录对比剂分别进入十二指肠及胆囊的时间.结果:Gd-EOBDTPA进入十二指肠的平均时间为(30±23) min,其中注射Gd-EOB-DTPA延迟扫描20 min时,对比剂进入十二指肠者所占比例为50.0％(15/30);延迟30 min时所占比例为70.0％(21/30);延迟60 min时所占比例为90.0％(27/30).对比剂进入胆囊的中位时间为10 min(6～29 min),其中注射Gd-EOB-DTPA延迟扫描15 min时,对比剂进入胆囊者所占比例为83.3％(25/30);延迟20 min时所占比例为93.3％(28/30);延迟30 min时所占比例为100％(30/30).对比剂进入十二指肠及胆囊时间与年龄无关(P＞0.05).结论:正常人行Gd-EOB-DTPA MRI增强扫描中,对比剂通过十二指肠乳头进入十二指肠的时间＜60 min,而通过胆囊管进入胆囊的时间＜30 min,此时间不仅可为Gd-EOB-DTPA MRI增强检查扫描时间方案的制定提供指导,同时可为临床上怀疑Oddi括约肌功能障碍或急性胆囊炎的排除诊断提供依据.     

Imaging features of intrahepatic cholangiocarcinoma in Gd-EOB-DTPA-enhanced MRI

Objective

The aim of this study is to describe the imaging features of intrahepatic cholangiocarcinoma in Gd-EOB-DTPA-enhanced MRI and to determine whether it results in improved tumour conspicuity of cholangiocarcinoma.

Materials and methods

Fifty-four patients with histologically proven intrahepatic cholangiocarcinoma underwent MRI of the liver using a 1.5 T MR-scanner with Gadoxetic acid disodium (Gd-EOB-DTPA; Eovist/Primovist, Bayer Healthcare, Berlin, Germany). The standard imaging protocol included a T2w multi-shot TSE sequence with fat saturation (fs), a T2w single shot sequence without fs and a T1w 3D GRE sequences with fs (unenhanced and arterial, portovenous, late venous and hepatobiliary phase). Two board certified radiologists experienced in liver MRI (5 and 10 years experience) evaluated retrospectively all MRI scans qualitatively and quantitatively. Signal was measured with region-of-interests (ROI) and signal-to-noise (SNR) as well as contrast-to-noise (CNR) was calculated. Statistical significance was tested with an ANOVA and a pairwise Wilcoxon rank test.

Results

All intrahepatic cholangiocarcinomas presented as hypointense lesions in the late venous and hepatobiliary phase. Images in the hepatobiliary phase showed the highest lesion conspicuity, i.e. n = 9 blurred (16.6%), n = 31 moderate (57.4%) and n = 14 sharp (26%). This was significantly higher than the lesion conspicuity of all other sequences or phases. Furthermore, the CNR was the highest in this sequence with 76.8 ± 51.3, with significantly higher values than the CNR of the unenhanced T1w sequence (CNR: 35.6 ± 21.0; p < 0.0001) and the arterial phase images (CNR: 53.6 ± 36.8; p < 0.001). The hepatobiliary phase images showed a SNR of 97.3 ± 59.7 (p < 0.001) and thus was significantly different from the unenhanced T1w sequence (SNR: 60.4 ± 35.3; p < 0.001), whereas the increase in SNR from the late venous to hepatobiliary phase was neglectable, indicating that no liver-specific contrast uptake is present in cholangiocarcinoma.

Conclusion

Intrahepatic cholangiocarcinoma presents as a hypointense lesion in Gd-EOB-DTPA-enhanced MRI in late venous phase images. The lesion conspicuity as well as CNR was highest in the hepatobiliary phase. Consequently, hepatobiliary phase images in Gd-EOB-DTPA-enhanced MRI images might be helpful for therapy planning due to the exact depiction of the tumour borders.     

Gd-EOB-DTPA增强MRI对肝细胞癌的诊断价值

目的:探究Gd-EOB-DTPA增强MRI对肝细胞瘤(HCC)的诊断价值.方法:纳入因疑诊HCC行Gd-EOB-DTPA增强MRI检查的患者48例.将患者图像分成A、B两组,A组包括平扫图像和动态增强图像;B组包括平扫图像、动态增强图像及肝胆期图像.比较两位阅片者在两组图像下诊断HCC的敏感度、特异度、阳性预测值和阴性预测值,并进行统计学分析.结果:B组图像诊断所有HCC的敏感度及阴性预测值高于A组图像,差异有统计学意义(P＜0.05).B组图像诊断直径＞2.0 cm HCC的阴性预测值高于A组图像,差异有统计学意义(P＜0.05).两位阅片者诊断一致性好(Kappa值均＞0.70).结论:含肝胆期的Gd-EOB-DTPA增强MRI能提高HCC的诊断准确度.     

Quantitative analysis of liver function using superparamagnetic iron oxide- and Gd-EOB-DTPA-enhanced MRI: comparison with Technetium-99m galactosyl serum albumin scintigraphy

Purpose

To examine whether or not the parameters regarding the signal intensity of the liver parenchyma on superparamagnetic iron oxide (SPIO)- and gadolinium ethoxybenzyl diethylenetriamine pentaacetic acid (Gd-EOB-DTPA)-enhanced MRI are correlated with the parameters of Technetium-99m galactosyl serum albumin (^99mTc-GSA) scintigraphy.

Materials and methods

This retrospective study consisted of 55 and 33 patients who underwent SPIO- and Gd-EOB-DTPA-enhanced MRI in addition to ^99mTc-GSA scintigraphy, respectively. For each patient, we calculated Pre R2* and Pre R2, which are equivalent to R2* (=1/T2*) and R2 (=1/T2) values of the liver parenchyma; ΔR2* and ΔR2, which represent differences in R2* and R2 values of the liver parenchyma before and after administration of SPIO; and the increase rates of both the liver-to-spleen signal intensity ratio (LSR) and the liver-to-major psoas muscle signal intensity ratio (LMR) on the hepatobiliary phase compared with the precontrast image. For ^99mTc-GSA scintigraphy, the receptor index LHL15 and the blood clearance index HH15 were recorded.

Results

Regression analysis showed a moderate correlation between Pre R2* and LHL15 (P < 0.05). Mild to moderate correlations were also obtained between any combination of ΔR2* and ΔR2 on the one hand, and LHL15 and HH15 on the other (P < 0.05). There were moderate correlations between any combination of increase rates of LSR and LMR on the one hand, and LHL15 and HH15 on the other (P < 0.05–0.001).

Conclusion

Pre R2*, ΔR2*, ΔR2 and the increase rates of LSR and LMR could be used as quantitative indicators of liver function.     

Diffusion-weighted PROPELLER MRI for quantitative assessment of liver tumor necrotic fraction and viable tumor volume in VX2 rabbits

PURPOSE: To test the hypothesis that diffusion-weighted (DW)-PROPELLER (periodically rotated overlapping parallel lines with enhanced reconstruction) MRI provides more accurate liver tumor necrotic fraction (NF) and viable tumor volume (VTV) measurements than conventional DW-SE-EPI (spin echo echo-planar imaging) methods. MATERIALS AND METHODS: Our institutional Animal Care and Use Committee approved all experiments. In six rabbits implanted with 10 VX2 liver tumors, DW-PROPELLER and DW-SE-EPI scans were performed at contiguous axial slice positions covering each tumor volume. Apparent diffusion coefficient maps of each tumor were used to generate spatially resolved tumor viability maps for NF and VTV measurements. We compared NF, whole tumor volume (WTV), and VTV measurements to corresponding reference standard histological measurements based on correlation and concordance coefficients and the Bland-Altman analysis. RESULTS: DW-PROPELLER generally improved image quality with less distortion compared to DW-SE-EPI. DW-PROPELLER NF, WTV, and VTV measurements were strongly correlated and satisfactorily concordant with histological measurements. DW-SE-EPI NF measurements were weakly correlated and poorly concordant with histological measurements. Bland-Altman analysis demonstrated that DW-PROPELLER WTV and VTV measurements were less biased from histological measurements than the corresponding DW-SE-EPI measurements. CONCLUSION: DW-PROPELLER MRI can provide spatially resolved liver tumor viability maps for accurate NF and VTV measurements, superior to DW-SE-EPI approaches. DW-PROPELLER measurements may serve as a noninvasive surrogate for pathology, offering the potential for more accurate assessments of therapy response than conventional anatomic size measurements.     

Simultaneous assessment of liver volume and whole liver fat content: a step towards one-stop shop preoperative MRI protocol

Objective  

The purpose of this study was to evaluate the ability of a whole liver volume (WLV) segmentation algorithm to measure fat fraction (FF).     

Gd-EOB-DTPA增强MRI定量评估肝脏储备功能的可行性研究

目的:以吲哚氰绿(ICG)15、Child-Pugh评分及终末期肝病模型(MELD)评分为金标准,评估Gd-EOB-DTPA增强MRI定量评估肝脏储备功能的可行性.方法:本研究纳入15例肝脏肿瘤患者及12例肝功能正常志愿者.所有受试者在术前(4周内)均进行了Gd-EOB-DTPA增强MRI检查、ICG清除试验、Child-Pugh评分及MELD评分,以肝细胞摄取率(HUI)作为评估肝脏储备功能的指标.采用Spearmanrank相关检验分析HUI与ICG15、Child-Pugh评分及MELD评分的相关性.结果:HUI与ICG15呈负相关(r=-0.718,P=0.003);HUI与Child-Pugh评分呈负相关(r=-0.663,P=0.007);HUI与MELD评分呈负相关(r=-0.711,P=0.003).12例小肝癌患者不同部位(肝左叶、右叶、尾叶)的HUI差异有统计学意义(P＜0.05)结论:Gd-EOB-DTPA增强MRI可以定量评估肝脏储备功能,并且能对不同叶段的肝脏储备功能进行分别描述.