The Application Research Of Gd-EOB-DTPA-enhanced MRI For The Evaluation Of Liver Function

PART I The Preliminary Study on Assessment of Liver Function by Gd-EOB-DTPA Enhanced Magenetic Resonance ImagingObjective To explore the fessibility of assessment of liver function by Gd-EOB-DTPA enhanced magenetic resonance imaging using different measurement indexes in the evaluation of hepatic parenchyma enhancement and the diagnostic efficacy of hepatic enhancement in the diagnosis of CPB-CPC and MELD score?9.Materials and Methods Imaging and biochemical results of 233 patients who were suspicious of chronic liver disease or focal liver lesions and underwent hepatic Gd-EOB-DTPA enhanced MRI were collected.The signal intensities of liver,spleen and erector muscle were measured in pre-contrast Ti-weighted images and the hepatocyte phase images.Image indexes included LSRpre,LMRpre,LSRHBP,LMRHBP,RLEs,RLEm,ISRs,ISRm,LSI,LMI,IRLSR and IRLMR were calculated.The one-way ANOVA,t-test,Kruskal-Willis H or Mann-Whitney U test were used to compare the biochemical indicators,scoring systems and image measurement indexes in different liver function groups.The receiver operating characteristic(ROC)curves were used to analyze the diagnostic efficacy of different image indexes for NLF-CPA or CPB-CPC and MELD score<8 or>9.Results There were 40 cases of NLF,162 cases of CPA,24 cases of CPB,7 cases of CPC,137 cases of 5 score in CPA,25 cases of 6 score in CPA.Of them,200 cases of MELD score<8,33 cases of MELD score>9 were included.Significant differences were found among NLF,CPA,CPB+CPC in all image indexes.LSRHBP,LMRHBP,RLEs,RLEm,ISRs,ISRm,LSI and IRLSR were found significant differences between any two groups.There were no significant differences between CPB and CPC in all image indexes.Significant differences were found not only between NLF-CPA and CPB-CPC in all image measurement indexes,but also between MELD score<8 and MELD score>9,while they were not found between CPB and CPC.The area under ROC curve of CPB-CPC and MELD score ?9 were respectively above 0.88 and 0.72 evaluating by LSRHBP,LMRHBP,RLEs,RLEm,ISRs,ISRm,LSI,LMI,IRLSR and IRLMR.Significant differences were found among NLF,5 score in CPA and 6 score in CPA evaluating by LSRHBP,LMRHBP,RLEs,RLEm,ISRs,ISRm,LSI,LMI,IRLSR and IRLMR.Conclusion The hepatic parenchyma enhancement in Gd-EOB-DTPA enhanced MRI decrease as the severity of liver cirrhosis advanced and can be used to evaluate liver function.The image indexes of liver parenchyma enhancement can be used as indexes for diagnosis of CPB-CPC and MELD score ?9.PART ? The Study on Correlation between Liver Parenchyma Enhancement in Gd-EOB-DTPA Enhanced MRI and Biochemical Indexes of Liver Function Objective To evaluate hepatobiliary magnetic resonance imaging using Gd-EOB-DTPA in relation to various biochemical indexes of liver function.Materials and Methods Imaging and biochemical results of patients who were suspicious of chronic liver disease or focal liver lesions and underwent hepatic Gd-EOB-DTPA enhanced MRI were collected.233 patients were included.The signal intensities of liver,spleen and erector muscle were measured in pre-contrast Ti-weighted images and the hepatocyte phase images.Image measurement indexes LSRpre,LMRpre,LSRHBP,LMRHBP,RLEs,RLEm,ISRs,ISRm,LSI,LMI,IRLSR and IRLMR were calculated.Pearson or Spearman correlation test were used to analyze the correlation between image indexes and biochemical parameters and scoring systems,and multiple regression analysis were used to determine the independent factors of biochemical parameters.Results All image indexes were correlated with PLT and Alb positively,and were correlated with AST,ALP,GGT,TBIL,DBIL,PT,INR,MELD score,APRI and FIB-4 negatively.Multiple regression showed MELD score was correlated with LSRHBP,LMRHBP,RLEs,RLEm,ISRm,LSI,LMI,IRLSR and IRLMR,Child-Pugh score and MELD score were correlated with ISRs.Conclusion The hepatic parenchyma enhancement in Gd-EOB-DTPA enhanced MRI correlates with several biochemical parameters and it correlates MELD score independently.