AIM To assess the accuracy of Look-Locker on gadolinium ethoxybenzyl diethylenetriamine pentaacetic acid(GdEOB-DTPA)-enhanced magnetic resonance imaging(MRI) for staging liver fibrosis in chronic hepatitis B/C(CHB/C)....AIM To assess the accuracy of Look-Locker on gadolinium ethoxybenzyl diethylenetriamine pentaacetic acid(GdEOB-DTPA)-enhanced magnetic resonance imaging(MRI) for staging liver fibrosis in chronic hepatitis B/C(CHB/C).METHODS We prospectively included 109 patients with CHB or CHC who underwent a 3.0-Tesla MRI examination, including T1-weighted and Look-Locker sequences for T1 mapping. Hepatocyte fractions(He F) and relaxation time reduction rate(RE) were measured for staging liver fibrosis. A receiver operating characteristic analysis using the area under the receiver operating characteristic curve(AUC) was used to compare thediagnostic performance in predicting liver fibrosis between He F and RE.RESULTS A total of 73 patients had both pathological results and MRI information. The number of patients in each fibrosis stage was evaluated semiquantitatively according to the METAVIR scoring system: F0, n = 23(31.5%); F1, n = 19(26.0%); F2, n = 13(17.8%); F3, n = 6(8.2%), and F4, n = 12(16.4%). He F by EOB enhancement imaging was significantly correlated with fibrosis stage(r =-0.808, P < 0.05). AUC values for diagnosis of any(≥ F1), significant(≥ F2) or advanced(≥ F3) fibrosis, and cirrhosis(F4) using He F were 0.837(0.733-0.913), 0.890(0.795-0.951), 0.957(0.881-0.990), and 0.957(0.882-0.991), respectively. He F measurement was more accurate than use of RE in establishing liver fibrosis staging, suggesting that calculation of He F is a superior noninvasive liver fibrosis staging method.CONCLUSION A T1 mapping-based He F method is an efficient diagnostic tool for the staging of liver fibrosis.展开更多
BACKGROUND: Excretion of gadolinium-ethoxybenzyl-diethyl- enetriamine pentaacetic acid (Gd-EOB-DTPA) in the bile may be related to liver function, because of elimination from the liver after preferential uptake by hep...BACKGROUND: Excretion of gadolinium-ethoxybenzyl-diethyl- enetriamine pentaacetic acid (Gd-EOB-DTPA) in the bile may be related to liver function, because of elimination from the liver after preferential uptake by hepatocytes. The purpose of this study was to investigate the relation between liver and biliary enhancement in patients with or without liver dysfunction, and to compare the tumor-to-liver contrast in these patients. METHODS: Forty patients [group 1: normal liver and Child Pugh class A in 20 patients, group 2: Child-Pugh class B in 18 patients and Child-Pugh C in 2] were evaluated. All patients underwent MR imaging of the liver using a 1.5-Tesla system. T1 weighted 3D images were obtained at 5, 10, 15 and 20 minutes after Gd-EOB-DTPA injection. The relation between group 3 (total bilirubin <1.8 mg/dL) and group 4 (total bilirubin ≥1.8 mg/dL) was investigated at 20 minutes. Liver and biliary signals were measured, and compared between groups 1 and 2 or groups 3 and 4. Tumor-to-liver ratio was also evaluated between groups 1 and 2. Scheffé’s post-hoc test after two-way repeated measures ANOVA and Pearson’s correlation test were used for statistical analysis. RESULTS: Liver enhancement showed significant difference at all time points between groups 1 and 2. Biliary enhancement did not show a significant difference between groups 1 and 2 at 5 minutes, but did at 10, 15 and 20 minutes. At 20 minutes significant differences between groups 3 and 4 were seen for liver and biliary enhancement. At all time points, liver enhancement correlated with biliary enhancement in both groups. At 5 minutes and 20 minutes, statistical differences between groups 1 and 2 were seen for tumor-to-liver ratio.CONCLUSIONS: The degree of biliary enhancement has a close correlation to that of liver enhancement. It is especially important that insufficient liver enhancement causes lower tumor-to-liver contrast in the hepatobiliary phase of Gd-EOB- DTPA.展开更多
基金Supported by National Natural Science Foundation of China,No.81771893,No.81771802,No.81471718 and No.81401376Outstanding youth Foundation of China Medical University,No.yq20160005
文摘AIM To assess the accuracy of Look-Locker on gadolinium ethoxybenzyl diethylenetriamine pentaacetic acid(GdEOB-DTPA)-enhanced magnetic resonance imaging(MRI) for staging liver fibrosis in chronic hepatitis B/C(CHB/C).METHODS We prospectively included 109 patients with CHB or CHC who underwent a 3.0-Tesla MRI examination, including T1-weighted and Look-Locker sequences for T1 mapping. Hepatocyte fractions(He F) and relaxation time reduction rate(RE) were measured for staging liver fibrosis. A receiver operating characteristic analysis using the area under the receiver operating characteristic curve(AUC) was used to compare thediagnostic performance in predicting liver fibrosis between He F and RE.RESULTS A total of 73 patients had both pathological results and MRI information. The number of patients in each fibrosis stage was evaluated semiquantitatively according to the METAVIR scoring system: F0, n = 23(31.5%); F1, n = 19(26.0%); F2, n = 13(17.8%); F3, n = 6(8.2%), and F4, n = 12(16.4%). He F by EOB enhancement imaging was significantly correlated with fibrosis stage(r =-0.808, P < 0.05). AUC values for diagnosis of any(≥ F1), significant(≥ F2) or advanced(≥ F3) fibrosis, and cirrhosis(F4) using He F were 0.837(0.733-0.913), 0.890(0.795-0.951), 0.957(0.881-0.990), and 0.957(0.882-0.991), respectively. He F measurement was more accurate than use of RE in establishing liver fibrosis staging, suggesting that calculation of He F is a superior noninvasive liver fibrosis staging method.CONCLUSION A T1 mapping-based He F method is an efficient diagnostic tool for the staging of liver fibrosis.
文摘BACKGROUND: Excretion of gadolinium-ethoxybenzyl-diethyl- enetriamine pentaacetic acid (Gd-EOB-DTPA) in the bile may be related to liver function, because of elimination from the liver after preferential uptake by hepatocytes. The purpose of this study was to investigate the relation between liver and biliary enhancement in patients with or without liver dysfunction, and to compare the tumor-to-liver contrast in these patients. METHODS: Forty patients [group 1: normal liver and Child Pugh class A in 20 patients, group 2: Child-Pugh class B in 18 patients and Child-Pugh C in 2] were evaluated. All patients underwent MR imaging of the liver using a 1.5-Tesla system. T1 weighted 3D images were obtained at 5, 10, 15 and 20 minutes after Gd-EOB-DTPA injection. The relation between group 3 (total bilirubin <1.8 mg/dL) and group 4 (total bilirubin ≥1.8 mg/dL) was investigated at 20 minutes. Liver and biliary signals were measured, and compared between groups 1 and 2 or groups 3 and 4. Tumor-to-liver ratio was also evaluated between groups 1 and 2. Scheffé’s post-hoc test after two-way repeated measures ANOVA and Pearson’s correlation test were used for statistical analysis. RESULTS: Liver enhancement showed significant difference at all time points between groups 1 and 2. Biliary enhancement did not show a significant difference between groups 1 and 2 at 5 minutes, but did at 10, 15 and 20 minutes. At 20 minutes significant differences between groups 3 and 4 were seen for liver and biliary enhancement. At all time points, liver enhancement correlated with biliary enhancement in both groups. At 5 minutes and 20 minutes, statistical differences between groups 1 and 2 were seen for tumor-to-liver ratio.CONCLUSIONS: The degree of biliary enhancement has a close correlation to that of liver enhancement. It is especially important that insufficient liver enhancement causes lower tumor-to-liver contrast in the hepatobiliary phase of Gd-EOB- DTPA.
