Assessment Of Liver Reserve Function By Gd-EOB-DTPA-Enhanced MRI Combined With Three-Dimensional Reconstruction

Objective(s): To evaluate the clinical value of Gd-EOB-DTPA-enhanced MRI combined with three-dimensional reconstruction for hepatic reserve function.Methods: A total of 97 patients with normal liver function and hepatitis B who underwent enhanced magnetic resonance examination of disodium gadolinium(Gd-Eo B-DTPA)and indolyanine green(ICG)clearance test in the First People’s Hospital of Yunnan Province from November 2018 to November 2022 were retrospectively enrolled.The subjects were divided into four groups according to the boundary of 10% and 30% ICG15 min retention rate(ICGR15).(Group N: normal liver function ICGR15 < 10%,17 cases;Group A: 33 cases with hepatitis B background ICGR15 < 10%;Group B: Hepatitis B background 10%≤ICGR15 < 30%,29 cases;Group C: Hepatitis B background ICGR15≥30%,18 cases).T1 WI images and T1 mapping images were analyzed before and 20 minutes after dynamic enhancement,and liver function parameters were obtained: SI(before enhancement),SI(after enhancement),liver relative enhancement(RE),T1 pre,T1post,and T1 relaxation time reduction rate(ΔT1).Based on the MRI scanning data,the 3D reconstruction model of liver was obtained by means of numerical deep learning technology,and liver volume parameters were obtained: liver volume LV,and standard liver volume(SLV)and standard liver volume rate(LV/SLV)were calculated.The volume binding function parameters ΔT1*LV,ΔT1*LV/SLV,RE*LV,RE*LV/SLV were calculated to investigate whether there were differences among different groups of liver reserve function.Single factor analysis of variance or rank sum test of independent samples were used to compare liver function parameters,volume parameters and volumetric combined function parameters of the four groups,and then Tukey HSD or Dunnett method was used to compare the two groups.Pearson correlation test was used to analyze the correlation between liver function parameters,volume parameters,volume-binding function parameters and ICGR15.Receiver operating characteristic curve(ROC)was used to evaluate the effectiveness of each parameter in diagnosing different liver reserve function.Results:Liver function parameters: SI(after enhancement),RE,T1 pre,T1post,ΔT1were significantly different among the four groups(P < 0.05).Volume parameters: LV,LV/SLV differences among the four groups were statistically significant(P <0.05);The volume binding function parameters of liver were ΔT1*LV,ΔT1*LV/SLV,RE*LV,RE*LV/SLV,and there were significant differences among the four groups(P< 0.05).ICG R15 was not significantly correlated with LV,LV/SLV(P > 0.05),but was significantly correlated with RE,ΔT1,ΔT1*LV,ΔT1*LV/SLV,RE*LV,RE*LV/SLV(P < 0.05).The correlation between ΔT1*LV/SLV was the strongest(r=-0.622,P < 0.01).In group N and group A,ΔT1(AUC=0.827)was the most effective diagnosis.RE*LV(AUC=0.988)was the most effective method to distinguish group N from group B.The diagnostic efficacy of RE*LV(AUC=1.000)was the highest in N group and C group.RE*LV(AUC=0.982)showed the highest diagnostic efficacy in group A and group B.RE*LV(AUC=0.981)showed the highest diagnostic efficiency in group A and Group C.The diagnostic efficacy of RE*LV(AUC=0.916)was the highest in group B and group C.Conclusion(s): 1 Gadoxetic acid disodium-enhanced magnetic resonance imaging combined with three-dimensional reconstruction can assess liver reserve function.2.Gadoxetic acid disodium-enhanced magnetic resonance imaging combined with 3D reconstruction is consistent with ICGR15 in assessing liver reserve function.3.Gadoxetic acid disodium-enhanced magnetic resonance imaging combined with 3D reconstruction can be used as a new method for assessing liver reserve function.