Gd-EOB-DTPA增强MRI评估功能性肝体积与肝功能Child-Pugh分级的相关性

目的：对比解剖性肝脏体积（ALV）和功能性肝脏体积（FLV）与肝功能Child-Pugh分级的相关性。方法：选择温州医科大学附属第二医院育英儿童医院2014年1月至2019年4月同时行增强CT和Gd-EOB-DTPA增强MRI扫描的肝硬化患者25例。对所有患者进行肝功能Child-Pugh评分，检测所有入组患者每个肝段的Gd-EOB-DTPA增强MRI平扫期和肝胆特异期的信号对比增强率（CER），以CT扫描的数据为基础利用MI-3DVS计算每个肝段的ALV和全肝的FLV。分析ALV和FLV与肝功能Child-Pugh分级的相关性。结果：肝功能Child-Pugh分级与ALV呈负相关（r=-0.792，P＜0.001），曲线拟合的决定系数（R2）=0.63；肝功能Child-Pugh分级与FLV亦呈负相关（r=-0.911，P＜0.001），曲线拟合的R2=0.80。FLV与肝功能Child-Pugh分级有更显著的负相关性。结论：结合Gd-EOB-DTPA增强MRI平扫期和肝胆特异期的信号CER和ALV计算所得的FLV较ALV能更好地反映肝脏的功能状态。

The association between functional liver volume and liver function evaluated by quantitative analysis of gadoxetic acid-enhanced magnetic resonance imaging

Objective: To compare correlations between FLV and Child-Pugh classification of liver function. Methods: All 25 patients with liver cirrhosis performed enhanced CT and Gd-EOB-DTPA-enhanced MRI were recruited in this study. The liver function of all cases was evaluated by Child-Pugh classification. The contrast enhancement ratio (CER) was analyzed by SIlh-SIlu/SIlu, and the volume of each liver segment measured by MI-3DVS. Then correlations between anatomical liver volume, functional liver volume and Child-Pugh classification of liver function analyzed. Results: Analyses showed that Child-Pugh classification of liver function was negatively correlated to the ALV (r=-0.792, P<0.001), with determination coefficient of curve fitting (R2=0.63); Child-Pugh classification of liver function was also negatively correlated with FLV (r=-0.911, P<0.001), determination coefficient of curve fitting (R2=0.80). Compared between the two analyzing methods of liver volume, FLV had more significant negative correlation with Child-Pugh classification of liver function. Conclusion: The FLV calculated by CER of Gd-EOB-DTPA-enhanced MRI combined with ALV from MI-3DVS could better reflect the liver function than ALV.