摘要
目的:研究使用钆塞酸二钠(Gd-EOB-DTPA)增强磁共振成像(MRI)评估慢性乙型肝炎(CHB)患者肝功能的可行性。方法:选取2022年10月1日至2023年12月10日江苏省中医院感染科收治的60例CHB患者进行前瞻性研究,所有患者均行Gd-EOB-DTPA增强MRI检查,计算各期信号强度比(SIR)、对比度增强指数(CEI),并与患者的Child-Pugh分级、肝脏实时剪切波弹性成像(SWE)以及无创肝纤维化模型APRI、FIB-4、GPR相比较。结果:不同Child-Pugh分级的SWE(P<0.001)、SIR肝胆期(P=0.005)、CEI肝胆期(P=0.003)、FIB-4(P<0.001)差异均有统计学意义。不同SWE水平CHB患者的SIR肝胆期(P=0.031)、CEI肝胆期(P=0.001)、FIB-4(P<0.001)差异均有统计学意义。低CEI肝胆期组与中CEI肝胆期组(P=0.017)、高CEI肝胆期组(P=0.022)之间的SWE差异有统计学意义,不同水平CEI肝胆期组间的Child-Pugh分布有差异(P=0.011)。CEI肝胆期水平与SWE呈负相关(r=-0.3973,P=0.0017),CEI肝胆期水平诊断Child-Pugh B+C级的曲线下面积(AUC)为0.720,灵敏度为0.818,特异度为0.605。结论:Gd-EOB-DTPA增强MRI可以较好地评估CHB患者的肝功能,CEI肝胆期水平可以定量地辅助诊断肝功能分级。
Objective:To study the performance of gadolinium ethoxybenzyl diethylenetriamine pentaacetic acid(Gd-EOB-DTPA)enhanced magnetic resonance imaging(MRI)for assessing liver function in patients with chronic hepatitis B(CHB).Methods:60 patients with CHB were included in this prospective study from Oct.1,2022 to Dec.10,2023.Gd-EOB-DTPA enhanced MRI was conducted,and then the signal intensity ratio(SIR)and contrast enhancement index(CEI)for each phase were calculated.SIR and CEI were compared with Child-Pugh grading,real-time shear wave elastography(SWE)and non-invasive liver fibrosis models including APRI,FIB-4,GPR.Results:SWE(P<0.001),SIR(P=0.005)and CEI(P=0.003)in the liver biliary phase(HBP),FIB-4(P<0.001)showed statistical differences in different Child-Pugh grades.Statistically significant differences were found in SIR HBP(P=0.031),CEI HBP(P=0.001)and FIB-4(P<0.001)of different SWE levels.SWE showed significant differencesbetween the low-level CEI HBP and the medium-level CEI HBP(P=0.017)as well as high-level CEI HBP(P=0.022).Child-Pugh levels showed differences among different CEI HBP group(P=0.011).A negative correlation was found between CEI HBP and SWE(r=-0.3973,P=0.0017).The area under the curve(AUC)of the CEI HBP level for Child Pugh B+C grade was 0.720,the sensitivity and specificity were 0.818 and 0.605,respectively.Conclusion:Gd-EOB-DTPA enhanced MRI is an effective method for evaluating liver function in patients with CHB.CEI HBP couldquantitatively measure liver function.
作者
李正军
徐祥涛
张帆
卢超
陆玮婷
LI Zhengjun;XU Xiangtao;ZHANG Fan;LU Chao;LU Weiting(Department of Radiology,Jiangsu Province Hospital of Chinese Medicine,Nanjing 210029,China;Department of Infectious Diseases,Jiangsu Province Hospital of Chinese Medicine,Nanjing 210029,China)
出处
《东南大学学报（医学版）》
CAS
2024年第1期64-71,共8页
Journal of Southeast University(Medical Science Edition)
基金
北京公益基金会项目(B21044ES)。
关键词
磁共振成像
钆塞酸二钠
慢性乙型肝炎
肝功能
magneticresonance imaging
gadolinium ethoxybenzyl diethylenetriamine pentaacetic acid
chronic hepatitis B
liver function
