Correlation Of Perfusion Parameters,liver Signaling Enhancement And Liver Function Of Primovist Dynamic Contrast-enhanced MR Imaging

Objective: To compare dynamic contrast-enhanced MR imaging perfusion parameters and hepatosplenic signal enhancement ratio with serum liver enzyme levels,Child-Pugh classification,and Indocyanine Green retention rate at 15 min,correlation and assessment of its diagnostic value for liver function.METHODS: Patients with clinically suspected or confirmed liver disease from September 2016 to January 2018 were included consecutively in the First Hospital of Lanzhou University.Simultaneous dynamic enhancement scan and Indocyanine Green excretion test were performed.For example,a SIEMENS Skyra 3.0T scanner was used for scanning,and SPM 8.0 was used for respiratory motion correction.The data was then imported into PMI 0.4 for analysis.Multi-period liver perfusion parameters were obtained;the corrected hepatosplenic enhancement signal ratio LSC-N(LSC-N,Normalised liver-to-spleen contrast ratio).A non-parametric Kruskal-Wallis test was used to assess differences between subject characteristics and different grades of liver function.To assess the relationship between the derived parameters of multi-phase hepatic perfusion,LSC-N and cholinesterase,total bilirubin,AST,ALT,and different grades of liver function.One-way analysis of variance was used to compare different groups of liver segments.The ICG R15 and Child-Pugh classifications were used as the gold standard to calculate the area under the curve values of UR,UF,and LSC in the diagnosis of liver function.RESULTS: Of the 72 patients,the Child-Pugh grade of liver function was A,55 cases;B,13 cases;C,4 cases.1.There was no significant correlation between AST,ALT and the derivative parameters of liver specific enhancement(P>0.05),APF had no significant correlation with cholinesterase and total bilirubin(P>0.05);VPF and cholinesterase showed There was a significant positive correlation(r=0.596,p=0.001).VPF was significantly negatively correlated with total bilirubin(r=-0.498,p=0.007);AFF was significantly negatively correlated with cholinesterase(r=-0.521).,p=0.004),was positively correlated with total bilirubin(r=0.457,p=0.014);UF,UR and cholinesterase were significantly positively correlated(r=0.608,0.632,p=0.001,p< 0.001);UF,UR were negatively correlated with total bilirubin levels(r=-0.739,-0.673,p<0.001),and LSC-N had a weak negative correlation with cholinesterase levels(r=-0.334;,p=0.004),there is a weak positive correlation with total bilirubin levels(r=0.232,p=0.046);2.There was no significant correlation between APF and grade of liver function.VPF was negatively correlated with grade of liver function(r=-0.51,p=0.006).AFF and LSC-N were positively correlated with grade of liver function(r=0.57,0.49,p).= 0.006,p<0.0001),UF,UR and liver function were significantly negatively correlated(r =-0.75,-0.74,p values were less than 0.0001);VPF,AFF,UF,UR and LSC-N in Child Pugh A There was a significant difference between B,A,and C,and UF and UR were significantly different between Child Pugh B and C.3.UF,UR and ICG R15 were significantly negatively correlated(r=-0.721,-0.686,p values were less than 0.0001);VPF,AFF,LSC-N and ICG R15 were positively correlated(r=-0.450,0.414,0.488,p=0.016,0.028,0.008).4.Treat ICG R15?10% as abnormal group and calculate the diagnostic cut-off value of UF,UR and LSC-N for diagnosis of abnormal liver function.When UF = 17.48%,the maximum index is 0.73.The sensitivity is 73% and the specificity is 100%.When UR = 2.51,the maximum index is 0.73.The sensitivity is 73%.The degree is 100%;when LSC-N=0.82,the maximum index is 0.64,and the sensitivity is 87% and the specificity is 77%.When distinguishing liver function between Child A grade and B grade,when UF = 17.49%,the maximum index is 0.90.Sensitivity is 90% and specificity is 0.80%.When UR = 2.51,the Yoden index is maximal.At 0.90,the sensitivity was 100% and the specificity was 90%.When LSC-N=0.82,the Youden index was a maximum of 0.59.The sensitivity was 90% and the specificity was 69%.When distinguishing liver function between Child B grade and C grade,when UF = 12.87%,the maximum index is 0.90,the sensitivity is 100%,and the specificity is 90%;when UR = 0.96,the Youden index is 0.90 maximum.Sensitivity is 100% and specificity is 90% at this time.Conclusion: The Primovist dynamic enhanced magnetic resonance perfusion parameters were significantly associated with total bilirubin,cholinesterase,Child-Pugh grade,and ICG R15,and were more correlated with LSC-N.They have diagnostic value in diagnosing abnormal liver function and can be used for In the abnormal liver function,A grade and B grade,B grade and C grade were identified.In summary,In summary,Pprimovist DCE-MRI perfusion parameters are expected to be a new method for assessing liver function.