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钆塞酸二钠增强T1 mapping成像肝功能评估肝胆期扫描时间的优化

Optimization of hepatobiliary phase scan time for the assessment of liver function using T1 mapping on Gd-EOB-DTPA-enhanced magnetic resonance imaging

    摘要
  • 摘要:
    目的 探讨钆塞酸二钠Gd-EOB-DTPA增强T1 mapping成像评估肝功能时合理的肝胆期扫描时间。
    方法 纳入124例乙肝肝硬化患者肝功能Child-Pugh A级(LCA)63例、B级(LCB)47例、C级(LCC)14例及23例健康体检者(NLF)。患者均采用Gd-EOB-DTPA行上腹部平扫及增强扫描, 并采用Look-Locker序列分别于平扫、增强后10 min、15 min及20 min采集T1 mapping图像。测量肝脏T1弛豫时间, 并计算增强后10 min、15 min及20 min肝脏T1弛豫时间减低率(ΔT1)及弛豫率增加值(ΔR1)。采用重复测量方差分析比较不同级别肝功能组不同时间T1、ΔT1及ΔR1, 采用ROC曲线评价T1、ΔT1及ΔR1鉴别NLF-LCA与LCB-LCC组的效能。
    结果 NLF、LCA、LCB组增强后10 min、15 min及20 min T1弛豫时间逐渐减低, ΔT1及ΔR1逐渐增加, LCC组增强后10 min、15 min及20 min T1弛豫时间逐渐增加, ΔT1逐渐减低。不同时间点T1弛豫时间、ΔT1及ΔR1差异均有统计学意义(F=23.125, 28.061, 67.421, P=0.000)。不同组别T1弛豫时间、ΔT1及ΔR1差异均有统计学意义(F=82.686、49.041、70.963, P=0.000)。增强后10 min、15 min与20 min的T1弛豫时间鉴别NLF-LCA与LCB-LCC组的ROC下面积分别为0.959、0.949、0.952。ΔT1鉴别两者的ROC下面积分别为0.880、0.879、0.894。ΔR1鉴别两者的ROC下面积分别为0.942、0.934、0.939。增强后10 min、15 min与20 min的T1弛豫时间、ΔT1及ΔR1 ROC下面积差异均无统计学意义。
    结论 采用钆塞酸二钠增强T1 mapping成像评估肝功能时, 于增强后10 min采集肝胆期图像可满足诊断需求。

     

    Abstract:
    Objective To investigate the hepatobiliary phase (HBP) scan time for the assessment of liver function using T1 mapping on Gd-EOB-DTPA-enhanced magnetic resonance imaging (MRI).
    Methods Totally, 124 patients with chronic viral hepatitis B and cirrhosis were classified into three groups as follows: liver cirrhosis with Child-Pugh A (LCA, n=63), Child-Pugh B (LCB, n=47), and Child-Pugh C (LCC, n=14). Twenty-three healthy volunteers with normal liver function (NLF) were enrolled as control group. All patients underwent Gd-EOB-DTPA-enhanced MRI. To obtain T1 mapping, Look-Locker sequences before and at 10, 15, and 20 minutes after Gd-EOB-DTPA administration were acquired. T1 relaxation time of liver was measured on T1 mapping, reduction rate of T1 relaxation time (ΔT1), and increase of relaxation rate (ΔR1) between pre- and post-enhancement were calculated. Repeated-measures analysis of variance was performed to compare T1 relaxation time, ΔT1, and ΔR1 among different liver function groups and different time points. Receiver operating characteristic (ROC) curve was drawn to determine the predictive effect of these parameters in discriminating NLF-LCA and LCB-LCC.
    Results T1 relaxation time of NLF, LCA, and LCB groups progressively increased from 10 min, 15 min to 20 min post-contrast, ΔT1 and ΔR1 showed a constant decrease from 10 min to 20 min. T1 relaxation time of LCC gradually decreased and ΔT1 increased from 10 min to 20 min. T1 relaxation time, ΔT1 and ΔR1 showed significant difference among different time points (F=23.125, 28.061, 67.421, P=0.000) and different groups (F=82.686, 49.041, 70.963, P=0.000). The areas under the ROC curve of T110 min, T115 min, and T120 min for discriminating NLF-LCA and LCB-LCC were 0.959, 0.949, and 0.952, respectively. The areas under the ROC curve of ΔT110 min, ΔT115 min, and ΔT120 min were 0.880, 0.879, and 0.894, respectively. The areas under ROC curve of ΔR110 min, ΔR115 min, and ΔR120 min were 0.942, 0.934, and 0.939, respectively. No significantly difference (P>0.05) was found among the three time points.
    Conclusions The 10 min HBP is feasible for assessing liver function using T1 mapping on Gd-EOB-DTPA-enhanced MRI.

     

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