The Study Of Gd-EOB-DTPA Enhanced MRI For The Evaluation Of Liver Function

Background and Objective:The evaluation of liver function affect patients’treatment strategies and prognosis, and plays a key role in clinics. However the indicators for liver function evaluation are limited and the assessment capacity of the indicators still has problems. To seek for a preferable and new noninvasive diagnostic imaging indicators particularly have an important clinical significance. Gd-EOB-DTPA is a novel contrast agent of magnetic resonance imaging (MRI), and normal liver cells can uptake it specifically, however the impaired function of liver cells decreased its uptake, so the contrast agent may have the ability to assess liver function. But now the study using this contrast agent to assess liver function is still rarely reported. Therefore this study was aimed to investigate the value of specifically enhanced MRI scan image of Gd-EOB-DTPA for evaluationof liver functioaMethods:The patients undergoing Gd-EOB-DTPA specifically enhanced scan by 1.5T MRI between June 2013-September 2014 in the First Hospital of Lanzhou University were screened. A total of 41 cases met the inclusion and exclusion criteria were included. Abdominal MRI scan, Gd-EOB-DTPA enhanced scan data and some clinical information were collected. Making the spleen as control organs for liver signal intensity, plain scan, 10min and 20min contrast ratio of liver/spleen signal intensity (SI liver/spleen) or liver relative degree of enhancernent(RLE) after injection of Gd-EOB-DTPA, and degree of liver enhancement after injection contrast agents 10min or 20min (10min SI liver/SIliver,20min SI liver/SI liver), the contrast ratio of 20min SI liver/10rnin SI liver. The statistical software was employed for data analysis.Results:1) After injection of contrast agent Gd-EOB-DTPA, 10min SI liver/spleen, 20min SI liver/spieen correlated negatively with Child classification (P<0.05), and 20min SI liver/spleen showed more correlation (r=-0.53), and SI liver/spleen in plain scan did not correlate with Child classification (P> 0.05).2) After injection of contrast agent Gd-EOB-DTPA,20min RLE also correlated negatively with Child classification (r=-0.36, P=0.049), and 10min RLE did not correlate with Child classification (P> 0.05)3) After injection of contrast agent Gd-EOB-DTPA 20min SI iiver/spleen between normal and elevated group of alanine aminotransferase or total bilirubin had significant differences (P<0.05).4) The indicator SI iiver/spleen in plain scan had no significant difference between patients with cirrhosis and non-cirrhotic, and after injection of contrast agent Gd-EOB-DTPA, 10min SIliver/spleen and 20min SI iiver/spleen,20min RLE had significant differences (P<0.05).5) After injection of contrast agent Gd-EOB-DTPA, the area under the curve (AUC) of 10min SI iiver/spleen for distinguish cirrhosis reached 0.709 (P<0.05), its cut-off value is 1.51, its sensitivity and specificity reached 0.89 and 0.54, respectively; the AUC of 20 min RLE for distinguish cirrhosis was 0.712 (P<0.05), its cut-off value is 0.39, its sensitivity and specificity were 0.82 and 0.62, respectively. The AUC of 20min SI liver/spleen showed no significant distinction capacity for distinguish cirrhosis (P> 0.05).Conclusion:1) After injection of contrast agent Gd-EOB-DTPA, reduced levels of 10min and 20min SIliver/spieen,20min RLE are closely related to deteriorated liver function 20min SI liver/spleen may be able to reflect necrosis and excretory function of liver cells, but further experiments are needed to be verified in future.2) After injection of contrast agent Gd-EOB-DTPA, 10min SI liver/spleen and 20min RLE which are closely related to liver cirrhosis might have certain diagnostic value for cirrhosis. They may be novel and potential diagnostic noninvasive indicators for cirrhosis.