磁共振增强T1 mapping和IVIM-DWI技术评估乙型肝炎肝硬化患者肝脏储备功能价值研究OACSTPCD
Assessment of liver reserve functions by IVIM-DWI and T1 mapping of Gd-EOB-DTPA enhanced MR scan in patients with hepatitis B-induced liver cirrhosis
目的 分析应用磁共振(MR)体素内不相干运动扩散加权成像(IVIM-DWI)和钆塞酸二钠增强T1 mapping参数评估乙型肝炎肝硬化患者肝脏储备功能的价值.方法 2020 年3 月～2022 年3 月我院诊治的乙型肝炎肝硬化患者60 例,接受吲哚菁绿15 min滞留率检测和MR增强扫描,测量增强前20 min和增强后20 min T1 弛豫时间,计算肝细胞增强分数,并应用Mltalytics 1.0.1 软件自动测算表观扩散系数(ADC)和真性水分子扩散系数(D).应用受试者工作特征(ROC)曲线分析参数评估肝储备的效能.结果 在60 例肝硬化患者中,吲哚菁绿15 min滞留率<10%者30 例(A组),≥10%但<30%者16 例(B组),≥30%者14 例(C组);C组增强前T1 弛豫时间和增强后T1 弛豫时间分别为(700.5±71.2)ms和(324.1±99.6)ms,显著长于A组[分别为(612.2±28.3)ms和(148.3±51.9)ms,P<0.05]或B组[分别为(682.5±73.1)ms和(256.2±88.1)ms,P<0.05],而ADC、D和肝细胞增强分数分别为(0.5±0.1)×103、(0.5±0.1)×103 和(50.2±11.6)%,均显著低于A组[分别为(1.2±0.1)×103、(1.0±0.4)×103 和(80.8±10.9)%,P<0.05]或B组[分别为(0.8±0.2)×103、(0.7±0.2)×103 和(59.4±19.7)%,P<0.05];ROC曲线分析显示,增强前和增强后20 min T1 弛豫时间、ADC、D和肝细胞增强分数评估乙型肝炎肝硬化患者肝脏储备功能均具有较高的价值(灵敏度均在 70.0%以上,特异度均在76.7%以上).结论 应用MR IVIM-DWI和T1 mapping参数评估乙型肝炎肝硬化患者肝脏储备功能具有很大的临床价值,可为临床决策提供影像学依据.
Objective This study was conducted to investigate the assessment of liver reserve functions by intra-voxel incoherent motion-diffusion weighted imaging(IVIM-DWI)and T1 mapping of Gd-EOB-DTPA enhanced MR scan in patients with hepatitis B-induced liver cirrhosis(LC).Methods Sixty patients with hepatitis B-induced LC were encountered in our hospital between March 2020 and March 2022,and all underwent indocyanine green 15 min retention detection and Gd-EOB-DTPA enhanced MR scan.The T1 relaxation times 20 minutes before and after enhancement were measured,and the hepatocyte enhancement fraction was calculated.The apparent diffusion coefficient(ADC)and the true water molecule diffusion coefficient(D)was automatically obtained by software Mltalytics 1.0.1.The diagnostic performance was evaluated by the receiver operating characteristic curve(ROC)analysis.Results Out of the 60 patient with hepatitis B-induced LC,the indocyanine green 15 min retention rates was found<10%in 30 case(group A),≥10%but<30%in 16 case(group B)and≥30%in 14 case(group C);the T1 relaxation times 20 minutes before and after enhancement in group C were(700.5±71.2)ms and(324.1±99.6)ms,much longer than[(612.2±28.3)ms and(148.3±51.9)ms,respectively,P<0.05]in group A or[(682.5±73.1)ms and(256.2±88.1)ms,respectively,P<0.05]in group B,while the ADC,the D and the hepatocyte enhancement fraction were(0.5±0.1)×103,(0.5±0.1)×103 and(50.2±11.6)%,all significantly lower than[(1.2±0.1)×103,(1.0±0.4)×103 and(80.8±10.9)%,P<0.05]in group A or[(0.8±0.2)×103,(0.7±0.2)×103 and(59.4±19.7)%,P<0.05]in group B;the ROC analysis showed that the T1 relaxation times 20 minutes before and after enhancement,ADC,D and hepatocyte enhancement fraction all had a promising diagnostic efficacy in assessing the liver reserve functions of patients with LC,with the sensitivities greater than 70.0%and the specificities greater than 76.7%.Conclusion The IVIM-DWI and T1 mapping parameters of MR is helpful in assessment of liver reserve functions in patients with LC,which might provide evidences for clinical decision-making.
穆玉娟;吴斐斐;陈莹
226600 江苏省南通市海安市人民医院影像科南通大学附属第三医院影像科
肝硬化磁共振成像体素内不相干运动扩散加权成像T1弛豫时间肝脏储备功能诊断
Liver cirrhosisMR scanIntra-voxel incoherent motion-diffusion weighted imagingQuantitative high-resolution longitudinal relaxation time imagingLiver reserve functionsDiagnosis
《实用肝脏病杂志》 2024 (001)
68-71 / 4
江苏省卫生健康委医学科研项目(编号:Z2019033);江苏省南通市卫生健康委指令性科研计划项目(编号:MS2022068)
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