Study On The Value Of Liver Specific Contrast Agent In The Evaluation Of Liver Function And The Value Of Research After Thermal Ablation Of Liver Cancer

Objective:1 ? The difference intaking contrast agent of different state liver function in GD-EOB-DTPA-enhanced liver MRI hepatobiliary phase,evaluation liver function of different state of liver function.2?GD-EOB-DTPA enhancement liver MR hepatobiliary phase evaluate local liver function of HCC TACE postoperation and microwave curing HCC after operation.Methods :1?Research object:a retrospective analysis of 50 cases of patients with focal lesions,which carried through GD-EOB-DTPA enhanced liver MRI.male 45 cases,5cases were female,aged 25 to 76 years old,average age(54.2-12.8).32 cases of patients with liver cirrhosis,18 cases of patients with liver cirrhosis.Inclusion criteria: focal lesions,the focal maximum diameter less than 10 cm;Images and clinical biochemical data is complete,can obtain general information and Child-Pugh grading index required.Exclusion criteria: severe movement artifacts;The liver diffuse placeholder;Severe renal insufficiency.2?the scanning methods: 3.0T superconducting Siemens Trio Tim magnetic resonance scanner and body phased coil were applied to examine.supine position,the upper abdomen in the centre of the body coil.Magnetic resonance imaging(MRI)scan sequence including T2 WI transection,T2 WI fat suppression transection,T1 WI and reverse phase,diffusion weighted imaging(DWI),3D interference phase volumesequence(VIBE)fat suppression transection,VIBE fat suppression of dynamic enhanced and delayed 20 min VIBE hepatobiliary phase.Avoid respiratory motion artifact,breathless training makes before the scan,scan after deep inhale and breathless.3 ? Cirrhosis cases were classified according to the Child-Pugh classification method,selected normal cases that liver ? kidney biochemical tests were regular as normal control group.4?Analysis ability of different function liver uptake of contrast agent.The difference of the signal enhancement degree(IS%)between the surrounding liver parenchyma and the average liver parenchyma after transcatheter arterial chemoembolization and microwave coagulation therapy for hepatocellular carcinoma.Results:IS% of the normal group is significant difference with Child-Pugh A grade,Pugh-Child B,Pugh-Child C grade group(P<0.05);IS% of the Child-Pugh A grade is significant difference with Pugh-Child B,Pugh-Child C grade group(P<0.05);IS% of the Child-Pugh B grade group has no significant difference with Pugh-Child C grade group(P=0.24);1 cases of liver cancer after interventional therapy and 2 cases of liver cancer after microwave coagulation of liver parenchyma IS% than the average liver parenchyma IS% decreased,13 cases of the liver parenchyma IS% compared with the average liver parenchyma IS% no significant difference(P=0.37).Conclusion :1? Different functional status of liver cells to absorb the degree of contrast medium is different,the normal control group,the Child-Pugh A group,the Child-Pugh class B group while liver function decline,the liver signal enhancement degree reduced on GD-EOB-DTPA enhanced MRI hepatobiliary phase?2? GD-EOB-DTPA enhanced MRI hepatobiliary phase show the liver function differencd of Child-Pugh B group and Child-Pugh C group is not sensitive.3? GD-EOB-DTPA enhanced MRI hepatobiliary phase showed the local function of HCC patients who treated with transcatheter arterial chemoembolization and microwave coagulation,liver signal enhancement in hepatobiliary phase can reflect the degree of liver cell function and local function.Objective:Compared with CT enhancement,to explore the liver specific contrast agent gadolinium acid(GD-EOB-DTPA)enhanced MR to evaluate the clinical value of after thermal ablation of liver cancer.Methods:1?Research object: thermal ablation therapy in patients with liver cancer,and have enhanced CT and GD-EOB-DTPA magnetic resonance enhanced follow-up data2 ? a retrospective analysis GD-EOB-DTPA-enhanced MRI data and CT enhancement image of clinical liver cancer patients after ablation,Patients absorbed all into MR dynamic enhancement,20 min delay liver imaging and dynamic CT imaging,Comparative analysis of GD-EOB-DTPA advantage evaluation after thermal ablation of liver cancer recurrence.Results:1?In 23 cases,14 cases had tumor recurrence,9 cases had no obvious signs of tumor recurrence;6 cases were single recurrent,6 cases of multiple.Detected with a total of 28 lesions,CT enhanced detected 22 lesions,GD-EOB-DTPA enhancement MRI were detected 29 lesions,One of them postoperative diagnosis is a small cysts,All lesions are low signal in hepatobiliary phase.2?GD-EOB-DTPA enhanced MRI and CT enhancement on lesions diagnostic sensitivity,specificity positive predictive value,negative predictive value and diagnostic accuracy respectively 100%,90%,97%,100%,97%.71%,82%,91%,53%,74%.GD-EOB-DTPA dynamic MR enhance the forecast evaluation after thermal ablation of liver cancer recurrence were superior to CT enhancement.conclusion:GD-EOB-DTPA evaluated recurrence and residual after thermal ablation is better than CT enhancement.GD-EOB-DTPA hepatobiliary phase reveal small lesions,multiple lesions had significant advantages;Also indirectly reflect liver function.