Gd-EOB-DTPA-enhanced MRI for the assessment of liver function and volume in liver cirrhosis

Objective:

The aims of this study were to use dynamic hepatocyte-specific contrast-enhanced MRI to evaluate liver volume and function in liver cirrhosis, correlate the results with standard scoring models and explore the inhomogeneous distribution of liver function in cirrhotic livers.

Methods:

10 patients with liver cirrhosis and 20 healthy volunteers, serving as controls, were included. Hepatic extraction fraction (HEF), input relative blood flow and mean transit time were calculated on a voxel-by-voxel basis using deconvolutional analysis. Segmental and total liver volumes as well as segmental and total hepatic extraction capacity, expressed in HEFml, were calculated. An incongruence score (IS) was constructed to reflect the uneven distribution of liver function. The Mann–Whitney U-test was used for group comparison of the quantitative liver function parameters, liver volumes and ISs. Correlations between liver function parameters and clinical scores were assessed using Spearman rank correlation.

Results:

Patients had larger parenchymal liver volume, lower hepatocyte function and more inhomogeneous distribution of function compared with healthy controls.

Conclusion:

The study demonstrates the non-homogeneous nature of liver cirrhosis and underlines the necessity of a liver function test able to compensate for the heterogeneous distribution of liver function in patients with diseased liver parenchyma.

Advances in knowledge:

The study describes a new way to quantitatively assess the hepatic uptake of gadoxetate or gadolinium ethoxybenzyl diethylenetriaminepentaacetic acid in the liver as a whole as well as on a segmental level.In patients undergoing liver resection, post-operative liver failure is a major concern and has in current practice become the biggest cause for mortality after liver resection [1–3]. Residual liver should be of adequate volume and quality to sustain immediate post-operative function and to allow regeneration for complete restoration of hepatic function. Currently, surgical decision-making is predominantly based on volume calculation from cross-sectional imaging, sometimes in combination with liver function evaluation [4,5]. A variety of different methods for quantitative assessment of global liver function are available, including clearance–retention tests, redox chemistry and scintigraphy [6,7]. All currently available metabolic tests give a global assessment of liver function and do not account or correct for the possible heterogeneous distribution of function within the liver parenchyma. Scoring models, of which the Child–Pugh score (CPS) [8,9] and the model for end-stage liver disease (MELD) [10] are the most frequently used, are hampered by the same limitations.A number of published studies, using different scintigraphic methods, have verified the presence of heterogeneous distribution of function in the liver parenchyma. In a group of patients with diverse underlying liver pathologies investigated with ^99mTc-mebrofenin, it was found that liver function was unevenly distributed within the liver [11]. Regional variations in uptake were also demonstrated using ^99mTc-labelled galactosyl human serum albumin [12,13]. This phenomenon was also observed in patients with primary sclerosing cholangitis using ^99mTc-HIDA [14].Gadoxetate or gadolinium ethoxybenzyl diethylenetriaminepentaacetic acid (Gd-EOB-DTPA; Primovist®, Bayer Healthcare, Berlin) is a contrast agent developed for MRI. It is a gadolinium chelate that is actively taken up into the hepatocytes through the organic anion-transporting polypeptides [15]. This is a property Gd-EOB-DTPA shares with the iminodiacetic acid compounds used in hepatobiliary scintigraphy (HBS) and with indocyanine green (ICG) [16–20]. Pharmacokinetic studies show that about 50% of the administered dose of Gd-EOB-DTPA is extracted by the liver and eliminated through the hepatobiliary pathway. The remaining 50% is eliminated by renal excretion [21]. As the hepatic elimination of Gd-EOB-DTPA is dependent on the integrity of the hepatocyte mass, quantification of the uptake should represent the same aspects of liver function as assessed by ICG clearance or HBS.Dynamic hepatocyte-specific contrast-enhanced MRI (DHCE-MRI) has previously been used in animal models for the evaluation of hepatic function in various experimental settings, either using semi-quantitative parameters or using deconvolutional analysis (DA) [22–25]. In human studies, liver parenchymal enhancement after administration of Gd-EOB-DTPA has been shown to correlate with ICG clearance and with liver cirrhosis as assessed by the CPS [26,27], and subsequent biliary excretion has been shown to be delayed in patients with impaired liver function [28]. In a study of patients with primary biliary cirrhosis, quantitative parameters indicative of liver function derived from DA were shown to correlate with disease severity [29]. Also, compartmental modelling has been used to assess the hepatic uptake of Gd-EOB-DTPA, and the parameters derived were shown to be dependent on the CPS [30]. These findings support the hypothesis that results from DHCE-MRI have the potential to assess liver function.The present study should be regarded as a feasibility study aiming to investigate DHCE-MRI as a method to explore the inhomogeneous distribution of liver function in patients with liver cirrhosis compared with a control group and to explore the correlation between DHCE-MRI-derived liver function parameters with commonly used clinical scoring models. The primary outcome was the overall hepatic extraction capacity of Gd-EOB-DTPA, and secondary outcomes were measures of liver function heterogeneity, liver function indices and correlation analysis.     

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.

     

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.     

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.     

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.     

Impact of menopausal status on background parenchymal enhancement and fibroglandular tissue on breast MRI

Objective

To evaluate the effect of menopausal status on the background parenchymal enhancement (BPE) and amount of fibroglandular tissue (FGT) on breast MRI.

Methods

Retrospective review identified 1,130 women who underwent screening breast MRI between July and November 2010. In 28 of these women, breast MRI was performed both at one time point while pre- and one time point while post-menopausal (median interval 49?months). Two independent readers blinded to menopausal status used categorical scales to rate BPE (minimal/mild/moderate/marked) and FGT (fatty/scattered/heterogeneously dense/dense). Consensus was reached when there was disagreement. The sign test was used to assess changes in rating categories, and the Spearman rank and Fisher’s exact tests were used to measure correlations and associations between variables.

Results

Significant proportions of women demonstrated decreases in BPE and FGT on post-menopausal breast MRI (P?=?0.0001 and P?=?0.0009). BPE category was unchanged in 39?% (11/28) and decreased in 61?% (17/28) of women. FGT category was unchanged in 61?% (17/28) and decreased in 39?% (11/28) of women. Age, reason for menopause, or interval between MRIs had no significant impact on changes in BPE and FGT.

Conclusion

On MRI, BPE, and FGT decrease after menopause in significant proportions of women; BPE decreases more than FGT.

Key Points

? On MRI, background parenchymal enhancement and fibroglandular tissue both decrease after menopause. ? The reduced postmenopausal enhancement is more marked in parenchyma than fibroglandular tissue. ? Background enhancement and fibroglandular tissue seen on MRI are under hormonal influence.     

绝经状态对于乳腺MRI中背景实质强化和纤维腺组织的影响

目的评价绝经状态对于乳腺MRI中背景实质增强和纤维腺组织数量的影响。方法回顾性研究2010年7月—11月进行乳腺MRI筛查的1130名妇女。这些妇女中有28名在绝经前和绝经后的一个时间点均进行了乳腺MR检查(中位数间隔49个月)。2位独立的阅片者对绝经状态采用盲法评价背景实质的强化(极少/轻度/中度/明显)和纤维腺组织(脂肪性/散在/不均匀致密/致密)的情况。当存在意见分歧时需协商达成共识。采用符号检验来评价等级类别的变化,采用Spearman秩和检验和Fisher确切检验来分析不同变量间的相关性。结果大多数妇女在绝经后的乳腺MRI中表现为背景实质强化和纤维腺组织减少(P=0.0001和P=0.0009)。背景实质强化类型在39%(11/28)的妇女中没有变化,而在61%(17/28)的妇女表现为减低。纤维腺组织类型在61%(17/28)的妇女没有变化,而在39%(11/28)的妇女中表现为减少。年龄、绝经原因和进行MRI的间隔对背景实质强化和纤维腺组织均无明显影响。结论 MRI中,大多数妇女在绝经后背景实质强化和纤维腺组织表现减少,背景实质强化改变要比纤维腺组织明显。     

Effect of lapatinib on hepatic parenchymal enhancement on gadoxetate disodium (EOB)-enhanced MRI scans of the rat liver

Purpose

The purpose of this study was to investigate the effect of lapatinib treatment on hepatic parenchymal enhancement on Gd-EOB-MRI scans in rat.

Materials and methods

Institutional animal review board approval was received prior to the commencement of all studies. Five rats received a single oral dose of 100 mg/kg/day lapatinib for 7 consecutive days. The controls (n = 5) were given 0.5 % (w/v) aqueous hydroxypropyl methyl cellulose containing 0.1 % (v/v) Tween 80 for 7 days. After the acquisition of gadoxetate disodium-enhanced MR images using 0.025 mmol gadolinium/kg, their livers were subjected to pathologic study to determine the expression level of organic anion-transporting polypeptide 1 (oatp1) and multi-drug resistance-associated protein 2 (mrp2).

Results

Relative enhancement of the liver was similar in both groups. At the hepatobiliary phase, which in rats occurs 3 min after the injection of Gd-EOB, it was 0.90 ± 0.06 in lapatinib-treated rats and 0.84 ± 0.08 in the controls (p = 0.30). There was also no difference in the expression level of oatp1 and mrp2.

Conclusion

In rats, the administration of lapatinib for 7 days had no effect on hepatic parenchymal enhancement on Gd-EOB-MRI scans.     

Gd-EOB-DTPA enhanced MRI of the liver: Correlation of relative hepatic enhancement,relative renal enhancement,and liver to kidneys enhancement ratio with serum hepatic enzyme levels and eGFR

Objectives

To assess the correlation of relative hepatic enhancement (RHE), relative renal enhancement (RRE) and liver to kidneys enhancement ratio (LKR) with serum hepatic enzyme levels and eGFR in Gd-EOB-DTPA enhanced MRI of the liver and to assess threshold levels for predicting enhancement of the liver parenchyma.

Methods

Data of 75 patients who underwent Gd-EOB-DTPA enhanced MRI of the liver were collected. Images were obtained before contrast injection, during the early arterial phase, late arterial phase, venous phase, delayed phase, and hepatobiliary phase which was 20 min after Gd-EOB-DTPA administration. Signal intensity of the liver and the kidneys in all phases was defined using region-of-interest measurements for relative enhancement calculation. Serum hepatic enzyme levels and eGFR were available in all patients. Spearman correlation test was used to test the correlation of RHE, RRE and LKR with serum hepatic enzyme levels and eGFR.

Results

In the hepatobiliary phase all serum hepatic enzymes were significantly correlated with RHE; total bilirubin (TBIL) and cholin esterase (CHE) showed strongest correlations. TBIL and CHE were significantly correlated with RRE in the arterial phases. TBIL and CHE were significantly correlated with LKR in the arterial phase and hepatobiliary phase. eGFR showed no correlation.

Conclusions

In Gd-EOB-DTPA enhanced MRI, TBIL and CHE levels may predict RHE, RRE and LKR.     

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.     

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.     

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...