The Application Of GD-EOB-DTPA-enhanced MR Imaging For The Evaluation Of Liver Function

When the liver is damaged by pathogenic factors,it will cause abnormalities in the structure and function of the liver.This is called Hepatic Insufficiency.The liver's compensatory mechanism often has the ability to compensate for mild damage.If the damage is too serious and widespread to compensate,it will cause serious abnormalities in the metabolism of the substance,detoxification,bile formation and excretion disorders,and bleeding tendency,namely liver dysfunction.The incidence of liver diseases in China is very high.Common causes include infection,chemical poisoning,biliary obstruction,blood circulation disorders and tumors.According to the pathogenesis,liver diseases can be divided into viral liver disease and non-viral liver disease.Viral liver disease includes viral hepatitis A,B,C,D,and E caused by 5 hepatitis viruses.Non-viral liver diseases mainly include alcohol liver diseases,drug or toxic liver diseases,metabolically abnormal liver diseases,and fatty liver diseases.These different sources of liver diseases will result in varying degrees of impaired liver function,manifested as a series of clinical symptoms.Whether it is chronic liver disease or liver tumor patients,timely and accurate liver function assessment can have a significant impact on clinical treatment strategies and treatment effects.At present,although there is no "gold standard" for liver function assessment in China,various methods for evaluating liver function are emerging one after another.Clinical evaluation is often performed using a simple and easy liver function score,such as Child-Pugh classification and model for end-stage liver disease(MELD),albumin-bilirubin(ALBI)score.The prealbumin-bilirubin(m ALBI)score is a liver function scoring model proposed by Japanese scholars in 2015.Studies have shown that the two are easier and more accurate than other scoring models.In recent years,studies have confirmed that adrenium ethoxybenzyl diethylenetriamine pentaacetic acid(Gd-EOB-DTPA)enhanced magnetic resonance imaging(MRI)can be used for liver function assessment,but its liver function evaluation results and ALBI The correlation between scores and m ALBI scores is not sufficient.In this study,Gd-EOB-DTPA enhanced MRI,ALBI score and m ALBI score were used as liver function evaluation methods to explore the correlation of the evaluation results.It is intended to further confirm the accuracy of Gd-EOB-DTPA enhanced MRI liver function assessment results and promote clinical Patients with liver dysfunction receive timely and effective treatment.Objective: To further confirm the feasibility of gadolinium ethoxybenzylObjective: To further confirm the feasibility of gadolinium ethoxybenzyl diethylenetriaminepentaacetic acid(Gd-EOB-DTPA)-enhand magnetic resonance imaging(MRI)to assess local liver function,and to explore its liver function assessment results with albumin-bilirubin(ALBI)scoring model and prealbumin-bilirubin(m ALBI)scoring model.Also explore the efficacy of Gd-EOB-DTPA enhanced MRI in the differential diagnosis of patients with impaired liver function.Materials and Methods: This study was a retrospective study and approved by the Research Ethics Committee of the Jingzhou Central Hospital of Hubei Province(the Second Clinical Hospital affiliated to Yangtze University).This study screened 36 patients who underwent 1.5T Gd-EOB-DTPA-enhanced MRI in the Department of Radiology,Jingzhou Central Hospital,Hubei Province from May 2017 to January 2019.All patients were enrolled in clinical history,laboratory examination data,and Child-Pugh group,ALBI score and m ALBI score.The Gd-EOB-DTPA-enhanced MRI examination of all enrollees measured the signal intensity(SIpre)of the unenhanced liver parenchyma,the signal intensity of the enhanced liver parenchyma(SIpost),the signal intensity of the erector spinae(SI muscle),the signal intensity of the portal vein(SI portal vein),all of which were calculated for relative enhancement of RE liver,RE muscle,and RE portal vein.Then(1)Observing the demographic data of all subjects,comparing the differences between the laboratory data of all subjects and the three kinds of liver function gradings;(2)Comparing the REof liver with three different kinds of liver function gradings;(3)Comparison the RE of left and right hepatic lobes.Explore differences between RE left lobe and RE right lobe in different liver function groups by ALBI score and m ALBI score;(4)Comparison the RE of muscle and portal vein of diffrernt liver function groups classified by ALBI score and m ALBI score;(5)Comparison of three relative enhancement levels of RE liver,RE muscle,and RE portal vein in hepatocyte specific to diagnose the efficacy of cirrhosis.Results:(1)Laboratory tests such as serum total bilirubin,albumin,prealbumin,and prothrombin time were statistically different from the three liver function grades(Child-Pugh grade,ALBI score,and m ALBI score).(P<0.05)(2)There were significant differences between the liver in most liver segments and even in all liver segments and in the three kinds of liver function gradings(Child-Pugh classification,ALBI score,and m ALBI score).(P<0.05)(3)RE of the left lobe and right lobe changed with liver function,but there was almost no statistical difference between the two RE.(4)There were significant differences in RE muscle,RE portal vein and liver function grading(ALBI score and m ALBI score)in most liver segments and even all liver segments.The difference was RE liver,RE muscle>RE portal vein.(P<0.05)(5)RE liver,RE muscle and RE portal vein can be used to differentiate between normal liver function and liver function impairment group.RE liver and RE muscle can differentiate between mild liver function injury group and moderate to severe liver injury group.Conclusion: Gd-EOB-DTPA-enhanced MRI can be used as an imaging method for liver function assessment.It can provide anatomical and functional information at the same time.The relative enhancement degree of RE liver,RE muscle and RE portal vein can be used as evaluation indicators,but RE liver RE muscles may be more suitable than RE portal veins.This study is still in the stage of clinical trials,and many related mechanisms and detailed grading standards are for further study.