摘要
目的探讨钆塞酸二钠(Gd-EOB-DTPA)增强磁共振成像(MRI)肝胆期对比剂摄取相关参数评估药物性肝损伤(DILI)患者肝损伤程度的价值。方法选择2020年1月至2021年6月扬州大学附属苏北人民医院收治的55例DILI患者,其中轻症DILI组29例,重症DILI组26例。选择同期30例肝功能正常患者(非DILI组)作为对照。回顾性分析患者Gd-EOB-DTPA增强MRI图像,测量增强前及增强后肝胆期肝脏、门静脉与脾脏信号强度,计算肝脏相对强化程度(RE)、肝脏相对于门静脉强化程度比(LPC)、肝脏相对于脾脏强化程度比(LSC),同时评价功能性肝脏影像评分(FLIS)。比较非DILI组、轻症DILI组、重症DILI组患者各参数差异。采用Pearson相关分析Gd-EOB-DTPA增强MRI肝胆期对比剂摄取相关参数与肝功能指标的相关性。绘制受试者操作特征(ROC)曲线分析Gd-EOB-DTPA增强MRI肝胆期对比剂摄取相关参数鉴别轻症DILI组与重症DILI组的效能。结果DILI组患者RE、LPC、LSC均低于非DILI组患者,且随着肝损伤程度的加重而降低,且差异均有统计学意义(P均<0.05)。RE、LPC与DILI患者总胆红素水平呈中度负相关(r=-0.53、-0.51,P<0.05),与DILI患者总蛋白水平呈中度正相关(r=0.54、0.53,P<0.05)。ROC曲线显示,RE、LPC、LSC、FLIS区分轻症DILI组与重症DILI组患者的曲线下面积(AUC)分别为0.74、0.81、0.74、0.78。结论Gd-EOB-DTPA增强MRI肝胆期对比剂摄取相关参数可评估DILI患者肝损伤程度,为临床定量评估DILI严重程度提供了新的辅助方法。
Objective To investigate the value of parameters obtained from gadolinium ethoxybenzyl diethylenetriamine pentaacetic acid(Gd-EOB-DTPA)uptake in hepatobiliary phase of enhanced magnetic resonance imaging(MRI)for evaluating the severity of drug induced liver injury.MethodsA total of 55 patients with drug induced liver injury admitted to North Jiangsu People's Hospital from January 2020 to June 2021 were selected,including 29 patients in the mild group and 26 patients in the severe group.Thirty patients with normal liver function were selected as control group.Gd-EOB-DTPA enhanced MRI images of patients were retrospectively analyzed.The signal intensity of liver,portal vein and spleen before enhancement and in hepatobiliary phase were measured,and the liver relative enhancement(RE),the enhancement degree of liver relative to portal vein(LPC),and the ratio of liver to spleen(LSC)were calculated.Functional liver imaging score(FLIS)was also performed.The parameters of the control group,mild drug-induced liver injury group and severe drug-induced liver injury group were compared.Pearson correlation analysis was used to analyze the correlation between hepatobiliary phase parameters and liver injury biochemical indexes in enhanced MRI.Receiver operating characteristic(ROC)curves were drawn to analyze the efficacy of different parameters in differentiating the mild and severe liver injury group.ResultsThe parameters of RE,LPC and LSC in patients with drug induced liver injury were lower than those in the control group,and the parameters decreased gradually with the aggravation of liver injury,with statistically significant differences(allP<0.05).RE and LPC were moderately negatively correlated with the level of total bilirubin(r=-0.53,-0.51,P<0.05)and moderately positively correlated with the level of total protein(r=0.54,0.53,P<0.05)in patients with drug induced liver injury.The areas under the ROC curve of RE,LPC,LSC,LFIS for distinguishing the mild and severe drug induced liver injury groups were 0.74,0.81,0.74,0.78 re
作者
王笑笑
胡景卉
刘金韵
陈俊飞
黄京城
罗先富
Xiaoxiao Wang;Jinghui Hu;Jinyun Liu;Junfei Chen;Jingcheng Huang;Xianfu Luo(Department of Radiology,Northern Jiangsu People's Hospital,Yangzhou 225001,China;Yangzhou Clinical Medical College,Dalian Medical University,Dalian 116011,China)
出处
《中华消化病与影像杂志（电子版）》
2022年第4期204-209,共6页
Chinese Journal of Digestion and Medical Imageology(Electronic Edition)
关键词
钆塞酸二钠
磁共振成像
药物性肝损伤
Gadolinium ethoxybenzyl diethylenetriamine pentaacetic acid
Magnetic resonance imaging
Drug induced liver injury
