Gd-BOPTA增强MRI肝胆期肝实质强化程度与肝纤维化分期的相关性

目的探讨钆贝葡胺(Gd-BOPTA)增强MRI肝胆期肝实质强化程度与肝纤维化分期的相关性。方法回顾性分析69例接受Gd-BOPTA增强MRI肝胆期扫描的肝病患者资料。所有患者均接受超声引导下右肝穿刺活检,并根据肝纤维化分级将患者分为5组(S0~S4组)。计算肝实质相对强化程度(RE):RE=(SI_(post)-SI_(pre))/SI_(pre),SI_(pre)为平扫时肝实质信号值,SI_(post)为Gd-BOPTA增强肝胆期肝实质信号值。采用单因素方差分析比较肝纤维化分期与肝胆期肝实质RE的差异性。采用Pearson相关性分析评估肝胆期肝实质RE与肝功能生化指标之间的相关性。结果Gd-BOPTA增强MRI肝胆期肝实质RE在肝纤维化分期的S0与S2组、S2与S4组间差异有统计学意义(P0.05),其他各组间两两比较差异均无统计学意义。肝胆期肝实质RE与总胆红素、丙氨酸氨基转移酶呈负相关(P0.05)。结论 Gd-BOPTA增强MRI肝胆期肝实质相对强化程度对无创性评估肝纤维化分期具有一定价值。

Relationship between stage of liver fibrosis and degree of liver parenchymal enhancement on hepatocyte phase of Gd-BOPTA-enhanced MRI

Objective To investigate the relationships between the stage of liver fibrosis and the degree of liver parenchymal enhancement on the hepatocyte-phase of Gd-BOPTA-enhanced MRI. Methods Totally 69 patients were enrolled who took the Gd-BOPTA-enhanced MRI and accepted the percutaneous liver biopsy guiding by ultrasound. Patients were classified into 5 groups according to the stage of liver fibrosis in the pathological findings (S0-S4 group). The relative enhancement ratio (RE) of the liver parenchyma in the T1-vibe sequence was calculated from measurement of the signal intensity before (SI_pre) and 90 min after the intravenous administration of Gd-BOPTA(SI_post), using the following formula:RE=(SI_post-SI_pre)/SI_pre. One-way ANOVA analysis of variance was used to compare the difference between the degree of the relative enhancement of hepatocyte phase (REh) on Gd-BOPTA-enhanced MR imaging and the stage of the liver fibrosis. Pearson''s product-moment correlation analysis was used to evaluate the relationship between the degree of REh on Gd-BOPTA-enhanced MRI and the levels of serologic liver functional parameters. Results There had significant difference of the REh of the hepatic parenchyma between S0 and S2 group, S2 group and S4 group (P<0.05), there was no significant difference between the other hepatic fibrosis groups. There were significant negative correlations between the REh of the hepatic parenchyma and the levels of serologic total bilirubin, alanine aminotransferase (P<0.05). Conclusion Measurement of the liver parenchymal REh on GD-BOPTA-enhanced MR imaging might be a non-invasive technique for assessing the stage of liver fibrosis.