摘要
目的研究钆塞酸二钠(Gd-EOB-DTPA)增强MRI联合残余肝脏体积测定在肝切除术前储备功能评估中的应用价值。方法本研究纳入2016年6月至2019年12月安徽省第二人民医院收治手术治疗的肝癌患者,所有患者均在术前进行Gd-EOB-DTPA增强MRI以及模拟肝切除并进行残余肝脏体积测定,并观察患者术后的肝功能恢复情况。结果本研究共纳入415例肝癌肝切除患者,其中56例患者发生了术后肝功能不全,发生率为13.5%。单因素分析分析发现术后肝功能不全组患者的术前血小板水平(P=0.036)及残余肝脏体积率(remnant liver volume rate,RLVR)×Gd-EOB-DTPA肝脏实际摄取信号强度(TSI)(P=0.012)明显低于良好组。术后肝功能不全组患者的肝门阻断时间(P=0.049)及术中出血量(P=0.032)明显高于术后恢复良好组。logistic多因素回归分析结果发现RLVR×TIS是肝癌肝切除术后肝功能不全的唯一危险因素。结论Gd-EOB-DTPA增强MRI联合残余肝脏体积测定可以较为准确的预测术后肝功能不全的发生,是一种较为可靠的肝脏储备功能评估手段。
Objective To study on the value of Gd-EOB-DTPA enhanced Magnetic Resonance Imaging(MRI)combined with residual liver volume measurement in evaluating liver reserve function before surgery.Methods A total of 415 liver cancer patients treated in our hospital from July 2016 to December 2019 were included in this study.All patients underwent Gd-EOB-DTPA enhanced MRI and residual liver volume measurement before operation.Liver function was observed after the surgery.Results 56 patients(13.5%)developed postoperative hepatic insufficiency.By univariate analysis it was revealed that preoperative platelet levels(P=0.036)and residual liver volume rate(RLVR)×Gd-EOB-DTPA actual liver uptake signal intensity(TSI)(P=0.012)of the patients in postoperative hepatic insufficiency group was significantly lower than those in the recovery group.Hepatic hilar occlusion time(P=0.049)and intraoperative blood loss(P=0.032)in patients with postoperative hepatic insufficiency group were significantly higher than those in postoperative recovery group.By logistic multivariate regression analysis it was found that RLVR×TIS was the only risk factor for postoperative hepatic insufficiency.Conclusion Gd-EOB-DTPA enhanced MRI combined with residual liver volume measurement can accurately predict the occurrence of postoperative hepatic insufficiency,and it is a reliable method for evaluating liver reserve function.
作者
贠桂侠
陆松
孟春
YUN Gui-xia;LU Song;MENG Chun(The Second people’s Hospital of Anhui Province,Hefei,230000,China)
出处
《肝脏》
2021年第4期388-391,共4页
Chinese Hepatology
基金
安徽省科技攻关项目(1604a0802095)。
关键词
磁共振成像
钆塞酸二钠
肝储备功能
术后肝功能不全
Magnetic Resonance Imaging
Laparoscopic
Gd-EOB-DTPA
Liver reserve function
Postoperative hepatic insufficiency
