| The morbidity of hepatic fibrosis and liver cirrhosis is very high in China.As the development of disease,hepatic can lead to liver cirrhosis and liver cirrhosis and lead to liver cancer eventually.Currently,the evaluation of hepatic fibrosis and liver cirrhosis depend mainly on live biopsy and the pathological diagnosis of liver cancer depends on post-operational examination of specimen.Liver biopsy has some limitations.We need a noninvasive modality to predict histological grade of hepatic fibrosis,liver cirrhosis and hepatocellular carcinoma.The research including:(1)Quantitative analysis of Gd-EOB-DTPA-enhanced MRI predicts histological grade of hepatocellular carcinoma;(2)Quantitative analysis of Gd-EOB-DTPA-enhanced MRI predicts histological grade of liver cirrhosis in rats;(3)The association between contrast enhancement ratio in Gd-EOB-DTPA-enhanced MRI and histological grades of different diseased liver tissue;(4)The association between functional liver volume and liver function evaluated by quantitative analysis of Gd-EOB-DTPA-enhanced MRI.Methods:(1)Gd-EOB-DTPA-enhanced MR imaging was performed on 95 patients with HCC before surgical resection.The signal absolute enhancement value(AEV)of tumor-to-tumor,the contrast enhancement ratio(CER)of tumor-to-tumor and tumor-to-liver were measured in 101 HCCs in 95 patients that were surgically resected in our institution.Pathological examination was carried out in tissue sections of a total of 101 surgical specimens.Then we analyzed the correlation among the signal absolute enhancement,the enhancement ratio and tumor histologic grade.(2)A11 40 SD rats were performed Gd-EOB-DTPA-enhanced MRI in different time point.The signal absolute enhancement value(AEV)and the contrast enhancement ratio(CER)were analyzed quantitatively.The specimens of rat liver were examed by Hematoxylin and Eosin staining and Masson staining in pathological test and liver cirrhosis was graded accordingly to Laennec system.Then we analyzed the correlation among the signal absolute enhancement,the enhancement ratio and histological grade of liver cirrhosis.(3)A11 55 patients were performed Gd-EOB-DTPA-enhanced MRI before surgery.The signal absolute enhancement value(AEV)and contrast enhancement ratio(CER)was analyzed quantitatively in the unenhancement and hepatobiliary phase of background liver.Then we analyzed the correlation among the signal absolute enhancement value,the contrast enhancement ratio and histologic grade liver fibrosis and liver cirrhosis.(4)All 25 patients with liver cirrhosis performed Gd-EOB-DTPA-enhanced MRI and enhanced CT were recruited in this study.The liver function of all cases was evaluated by Child-Pugh classification.The contrast enhancement ratios were analyzed by SIlh-SIlu/SIlu,and the volume of each liver segment was measured by MI-3DVS.The FLVs were calculated by equation of FLV=?vol×?CER+?vol×?CER+……+?vol×?CER.Then we analyzed correlations among anatomical liver volume,functional liver volume and Child-Pugh classification of liver function.Results:(1)We analyzed the correlation of the absolute enhancement value of tumor-to-tumor and the grades of tumor differentiation(r=-0.492,P<0.05),the correlation of contrast enhancement ratio of tumor-to-tumor and the grades of tumor differentiation(r=-0.109,P>0.05)and the correlation of contrast enhancement ratio of tumor-to-liver and the grades of tumor differentiation(r=-0.775,P<0.05).Among the three analyzed methods of signal intensity,we confirmed the most significant negative correlation between contrast enhancement ratio of tumor-to-liver and the grades of tumor differentiation.The cut-off values calculated by receiver operating characteristic curve(ROC curve)were 0.535 between grade ? and ?,0.40 between grade ? and ?,0.295 between grade ? and ?,respectively.The k-value for contrast enhancement ratio of tumor-to-liver and histopaihologic analysis was 0.62,which indicates good agreement.(2)The mortality rate of experimental group was 23.35(7/30),and we analyzed the correlation of the signal absolute enhancement and histological grade of liver cirrhosis(r =-0.695,p<0.001),the correlation of contrast enhancement ratio and histological grade of liver cirrhosis(r =-0.893,p<0.001).Between the two analyzed methods of signal intensity,we confirmed the more significant negative correlation between contrast enhancement ratio and histological grade of liver cirrhosis.The cut-off values calculated by receiver operating characteristic curve(ROC curve)were 0.535 between mild and moderate liver cirrhosis,0.335 between moderate and severe liver cirrhosis,respectively.The k-value for contrast enhancement ratio and histopathologic analysis was 0.73,which indicates good agreement.(3)We analyzed the correlation of the absolute signal enhancement and the histological grades of different diseased hepatic tissue(r =-0.526,p<0.001)and the correlation of contrast enhancement ratio and the histological grades of different diseased hepatic tissue(r =-0.741,p<0.001).And also,we analyzed the correlation of the absolute signal enhancement and the histological grades of liver cirrhosis(r =-0.572,p<0.001)and the correlation of the contrast enhancement ratio and the histological grades of liver cirrhosis(r =-0.765,p<0.001).Between the two analyzed methods of signal intensity,we confirmed the most significant negative correlation between contrast enhancement ratio and the histological grades of different diseased hepatic tissue and liver cirrhosis.The cut-off values calculated by receiver operating characteristic curve(ROC curve)were 0.76 between normal hepatic tissue and liver fibrosis,0.46 between liver fibrosis and liver cirrhosis,respectively.The k-value for contrast enhancement ratio and histopathologic analysis was 0.41,which indicates moderate agreement.The cut-off values calculated by ROC curve were 0.425 between mild and moderate liver cirrhosis,0.325 between moderate and severe liver cirrhosis,respectively.The k-value for contrast enhancement ratio and histopathologic analysis was 0.60,which indicates good agreement.(4)We analyzed the correlation of the ALV and Child-Pugh classification of liver function(r =-0.792,p<0.001),the correlation of FLV and Child-Pugh classification of liver function(r =-0.911,P<0.001).Between the two analyzed methods of liver volume,we confirmed the more significant negative correlation between FLV and Child-Pugh classification of liver function.Conclusion:(1)Quantitative analysis of Gd-EOB-DTPA-enhanced MRI can predict the histologic grades of HCCs.(2)There were significant correlation between contrast enhancement ratio and histological grades of liver cirrhosis by quantitative analysis of gadoxetic acid-enhanced MR imaging.The calculation of contrast enhancement ratio can predict histological grade of liver cirrhosis.(3)The most significant negative correlations between contrast enhancement ratio and the histological grades of different diseased hepatic tissue and liver cirrhosis were confirmed by quantitative analysis of Gd-EOB-DTPA-enhanced MRI and the analysis of contrast enhancement ratio can predict the histological grades of liver cirrhosis.(4)The FLV calculated by combining contrast enhancement ratio(CER)of Gd-EOB-DTPA-enhanced MRI with anatomical liver volume(ALV)of MI-3DVS attains integration of regional liver function and reflects the liver function better than ALV. |
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