Comparative Study Of Clinical Value Of Gd-EOB-DTPA Enhanced MRI And T1 Mapping In Evaluating Liver Fibrosis Grading

Objective:To compare the clinical value of liver specific contrast agent Gd-EOB-DTPA enhanced magnetic resonance imaging and T1 mapping in the evaluation of liver fibrosis staging.Methods:Twenty seven patients who were diagnosed and treated in the First Hospital of Lanzhou University from January 2018 to February 2019 were enrolled in this study.All subjects underwent liver biopsy and used 3.0T(Siemens Magnetom Skyra 3.0T,Germany)MR to perform Gd-EOB-DTPA dynamic enhancement and T1 mapping scan.The original MRI images were imported into the Siemens workstation for processing.The signal intensity value(S1)and T1 value of the pre-contrast and hepatobiliary phase were obtained,and the relative enhancement value RE and the T1 value change rate ?T1% were calculated by calculation.One-way analysis of variance was used to compare the signal intensity values(S1)and T1 values of pre-enhancement and hepatobiliary phases,RE,and ?T1% between different groups.LSD-t test was used to compare the two groups in different fibrosis groups;Kendall's tau-b correlation coefficient was used to evaluate the correlation between each measurement and liver fibrosis;and liver biopsy was used as the gold standard,and ROC curve was used to analyze the diagnostic performance of SI and T1 values of hepatobiliary phase,RE,and ?T1% for liver fibrosis staging.RESULTS:In the 27 patients,the pathological grades of liver fibrosis were S0 7 cases,S1 4 cases,S2 5 cases,S3 5 cases,S4 6 cases respectively.1.RE,?T1% and hepatobiliary SI decrease with the increase of liver fibrosis,and the T1 value of hepatobiliary phase increases with the degree of liver fibrosis.RE,?T1%,SI and T1 values of hepatobiliary phase in different groups were statistically significant difference in between the two groups.There were no significant difference in SI between the S1 and S2,S2 and S3,S3 and S4 groups(P>0.05),in RE between the S0 and S1,S2 and S3,S3 and S4 groups(P>0.05),and in T1 values only between the S1 and S2 groups(P=0.126),and in ?T1% between the S0 and S1,S1 and S2,S2 and S3,S3 and S4 groups(P>0.05).The differences between another groups were statistically significant;the difference of pre-enhanced SI was not statistically significant;the pre-enhanced T1 values were only different between S4 and S0-S3.2.There was a strong negative correlation between hepatobiliary phase SI and hepatic fibrosis(Kendall's tau-b=-0.782,P<0.001);RE value was significantly negatively correlated with liver fibrosis(Kendall's tau-b=-0.786,P<0.001);T1 value of hepatobiliary phase was significantly positively correlated with liver fibrosis(Kendall's tau-b=0.807,P<0.001);?T1% was significantly negatively correlated with liver fibrosis(Kendall's tau-b=-0.744,P<0.001);there was no correlation between pre-enhanced SI and liver fibrosis grade,(Kendall's tau-b=-0.306,P=0.06),while the pre-enhanced T1 value was weakly positively correlated with liver fibrosis grade(Kendall's taub=0.459,P=0.002).3.Different staging of liver fibrosis :?S1,?S2,?S3 and S4 were identified by the hepatobiliary phase SI,RE,hepatobiliary phase T1 values and ?T1%.The area of under the ROC curve(AUC)were(0.94,0.95,0.96,0.96),(0.94,0.95,0.96,0.96),(0.92,0.94,0.97,0.97)and(0.96,0.96,0.95,0.94)respectively.Conclusion:1.The hepatobiliary phase SI,RE,T1 value of hepatobiliary phase and ?T1% are related to the degree of liver fibrosis.2.The hepatobiliary phase T1 value and ?T1% are generally superior to the hepatobiliary phase SI and RE in the diagnosis of liver fibrosis grading,especially in the evaluation of early liver fibrosis.