摘要
目的:探讨临床试验指标在普美显(Gd-EOB-DTPA,钆塞酸二钠)磁共振增强扫描肝胆特异期肝实质强化程度的影响及其临床意义.方法:研究收集接受普美显MRI增强扫描检查的患者96例,所有患者在接受检查前后2周内进行实验室检查指标的检测,包含白蛋白、总胆红素(TB)、丙氨酸转氨酶(ALT)、天冬氨酸转氨酶(AST)以及血小板比率指数(APRI).然后对比实验室检查指标与增强扫描前后T1衰减率的关系.相关性比较采用Pearson检验.最后对比分析各实验室指标的独立影响因素,绘制受试者表达ROC曲线,评估各个临床试验指标在Gd-EOB-DTPA MRI增强扫描肝胆特异期肝实质强中的意义.结果:① 96例Gd-EOB-DTPA MRI增强扫描患者接受临床试验指标的检查结果显示,阳性73例,阴性23例,即73例患者的T1衰减率受到临床试验指标的影响,而23例患者两者之间没有相关性;②经Pearson检验分析后发现,T1衰减率与TB、ALT(AST)、APRI表现为负相关,其系数r分别为:-0.501、-0.412、-0.382,P<0.001.而与白蛋白表现为正相关,r为0.253,P=0.001;③独立影响因素分析显示,回归系数分别为:白蛋白(β=0.190,P=0.042)、TB(β=-0.420,P<0.001)以及APRI(β=-0.162, P=0.037);④分析绘制的ROC曲线后显示,白蛋白、TB以及APRI范围分别为:>39g/L、≤14.7μmol/L、≤1.1721.结论:肝功能的改变会影响Gd-EOB-DTPA MR增强扫描肝实质在肝胆特异期的强化程度,强化程度与临床试验指标有相关性,白蛋白降低、TB与APRI升高则肝实质强化程度减低.
Objective To investigate the effect of clinical test parameters on hepatic parenchymal enhancement in hepatobiliary specific phase by gadolinium ethoxybenzyldiethy-lenetriaminepentaacetic acid(Gd-EOB-DTPA) enhanced magnetic resonance imaging and its clinical significance. Methods A total of 96 patients receiving enhanced Gd-EOB-DTPA MRI scans were studied. All patients underwent laboratory tests within 2 weeks before and after the examination, including albumin, total bilitubin, alanine aminotransferase(ALT), aspertate aminotransferase(AST) and platelet ratio index(APRI). Then the relationship between laboratory test indexes and T1 attenuation rate before and after enhanced scanning was compared. Pearson test was used for correlation comparison. Finally, the independent influencing factors of each laboratory test index were compared and analyzed, and the ROC curve of subjects was drawn. The significance of clinical test parameters on hepatic parenchymal enhancement in hepatobiliary specific phase by gadolinium disodium sebacate(Gd-EOB-DTPA) enhanced magnetic resonance imaging was evaluated. Results(1) The results of 96 patients with enhanced Gd-EOB-DTPA MRI scan showed that 73 were positive and 23 were negative, that is the T1 attenuation rate of 73 patients was affected by the clinical test index, but there was no correlation between them in 23 patients.(2) After Pearson test analysis, it was found that T1 attenuation rate was negatively correlated with TB, ALT(AST) and APRI, and the coefficients r were -0.501,-0.412 and -0.382, respectively, P<0.00, while positive correlated with albumin, r was 0.253, P=0.001.(3) Independent factor analysis showed that the regression coefficients were albumin(β=0.190, P=0.042), TB(β=-0.420, P<0.001) and APRI β=-0.162, P=0.037).(4) The ROC curves showed that the ranges of albumin, TB and APRI were >39 g/L, ≤14.7μmol/L and ≤1.1721, respectively. Conclusion Changes in liver function may affect the enhancement of hepatic parenchyma in hepatobiliary specific phase on enhanced Gd-EOB-DTPA MR scan. The degree of enhancement is correlated with clinical test indexes. Decreased albumin and elevated TB, APRI may reduce the enhancement of hepatic parenchyma.
作者
兰庆花
陈怡静
张永学
Lan Qing-hua;Chen Yi-jing;Zhang Yong-xue(Suining Central Hospital (Suining Central Hospital Affiliated tv Chongqing Medical University) Radiography Department,Suining 629000,China;Department of Imaging,Renhe Hospital,Three Gorges University,Yichang 443001,China)
出处
《湖南师范大学学报（医学版）》
2019年第5期21-25,共5页
Journal of Hunan Normal University(Medical Sciences)
基金
三峡大学2012年度人才科研启动基金项目（KJ2012A015）
关键词
临床使用试验指标
普美显
肝胆特异期
肝实质强化程度
影响
clinical trial indicators
Gd-EOB-DTPA
hepatobiliary specific phase
enhancement of liver parenchyma
influence
