The Value Of Gd-EOB-DTPA-enhanced MRI Examination In The Evaluation Of Liver Function Before The Surgery Of Hepatic Alveolar Echinococcosis

Obiective: To investigate the feasibility of liver and erector spinae Increased signal(IS%)in the evaluation of hepatic function before hepatic alveolar echinococcosis(HAE)in patients with disodium citrate(Gd-EOB-DTPA)enhanced MRI.Methods: The data of HAE patients who underwent Gd-EOB-DTPA enhanced MRI and concurrent indocyanine green excretion test from June 2017 to July 2019 in Qinghai University Affiliated Hospital were collected.A total of 54 patients were classified according to Child-Pugh classification.Group,27 patients in the A group,17 in the B group,and 10 in the C group.The pre-and post-enhanced signal intensity(SI)of the liver segments and erector spinae were measured on the plain and hepatobiliary images,and the percentage increase of liver and erector spinae signal ratio(IS%)was calculated.The volume ratio of the patient's vesicular echinococcal lesion to the whole liver was calculated by the post-processing workstation(Vlesion/Vliver).Record 15 min retention of indocyanine green in patients with total bilirubin(TBIL)<51 ?mol/L(ICG-15 min retention).To analyze whether the differences in IS%,Vlesion/Vliver,and ICG-15 min retention rate of different liver function levels are statistically significant.The Child-Pugh classification and ICG-15 min retention rate were used as criteria for evaluation of liver function,and the correlation between IS% and Child–Pugh classification,ICG-15 min retention rate,and V lesion/V liver was analyzed.Result:(1)There was no significant difference in IS% between grade A and grade B(P>0.05),There was significant difference between grade C and other groups(P<0.05).There were no significant differences in Vlesions/Vliver between the three groups(P>0.05).(2)All patients with TBIL>51?mol/L were removed(A total of 13 cases were removed,including 3 cases in the B group and 10 in the C group),There was no significant difference in ICG-15 min retention between group A and remaining group B(P>0.05).(3)There was a negative correlation between IS% and Child–Pugh grade(r=-0.427,P<0.01).After removing all patients with TBIL>51?mol/L,IS% was negatively correlated with ICG-15 min retention rate(r=-0.630,P<0.01).(4)Vlesion/Vliver has no correlation with Child–Pugh classification and IS%.Conclusion: The IS% in Gd-EOB-DTPA-enhanced MRI was negatively correlated with the Child–Pugh grade.In patients with TBIL<51?mol/L,the correlation between IS% and ICG-15 min retention was better.when TBIL>51?mol/L,IS% can identifythe C group and the A and B groups.Vlesion/Vliver did not differ between the three groups,It is not related to Child–Pugh classification and IS%,indicating that the size of the lesion and the size of the remaining liver volume do not reflect liver function.In summary,Gd-EOB-DTPA enhanced MRI can be used to initially assess liver function.