AIM: To investigate the value of magnetic resonance elastography(MRE) with regard to assessing liver functional reserve.METHODS: Data from inpatients diagnosed with a liver tumor at an interventional radiology departm...AIM: To investigate the value of magnetic resonance elastography(MRE) with regard to assessing liver functional reserve.METHODS: Data from inpatients diagnosed with a liver tumor at an interventional radiology department from July 2013 to June 2014 were analyzed. A 3.0 Tesla magnetic resonance unit was used to scan 32 patients with confirmed diagnoses of hepatocellular carcinoma(HCC); an MRE sequence was added to the protocol, and the data were reconstructed and analyzed by two attending radiologists. Regions of interest were identified in different slices of the non-tumor liver parenchyma to measure average stiffness. In addition, the indocyanine green(ICG) test was performed no more than 1 wk before or after the magnetic resonance examination for all 32 patients; the ICG retention rate at 15 min(ICGR-15) and the ICG plasma clearance rate(ICG-K) were recorded. Correlational analyses were performed between the liver stiffness values and the ICGR-15 as well as between the liver stiffness values and the ICG-K.RESULTS: Magnetic resonance imaging, including an MRE sequence and the ICG test, was performed successfully in all 32 enrolled patients. None of the patients developed complications. The mean ± SD of the elasticity values measured by the two attending radiologists were 4.7 ± 2.2 k Pa and 4.7 ± 2.1 k Pa, respectively. The average liver stiffness value of the non-tumor parenchyma measured using MRE in HCC patients was 4.7 ± 2.2 k Pa. The average ICGR-15 was 0.089 ± 0.077, and the average ICG-K was 0.19 ± 0.07. We found that the liver stiffness value of the non-tumor parenchyma was significantly and positively related to the ICGR-15(r = 0.746, P < 0.01) as well as significantly and negatively related to the ICG-K(r =-0.599, P < 0.01). The ICGR-15 was significantly and negatively related to the ICG-K(r =-0.852, P < 0.01).CONCLUSION: MRE is accurate and non-invasive; furthermore, it can be used to effectively assess the liver functional reserve of HCC patients.展开更多
AIM:To investigate the clinical usefulness of a newly developed index,the "index of convexity(IOC)",for evaluating liver functional reserve using technetium99m-diethylenetriaminepentaacetic acid-galactosylhu...AIM:To investigate the clinical usefulness of a newly developed index,the "index of convexity(IOC)",for evaluating liver functional reserve using technetium99m-diethylenetriaminepentaacetic acid-galactosylhuman serum albumin(Tc-GSA scintigraphy).METHODS:In total,349 patients underwent Tc-GSA scintigraphy.Dynamic planner images were obtained,and time activity curves of the liver and heart were generated and analyzed.Our focus was on the convex shape of the liver accumulation curve.We developed a method for evaluating the extent of convexity and calculated an index that we named the IOC.Clearance index and receptor index were also calculated.The correlations between each GSA index with other liver function tests and liver histopathology were evaluated.RESULTS:Among the 3 indices generated by TcGSA,the IOC had the highest correlation with all other liver function tests(indocyanine green R15,albumin,prothrombin time,cholinesterase level,platelet count,and total bilirubin level).IOC can also differentiate between normal liver,chronic hepatitis,and liver cirrhosis with highest F ratio among GSA indices as determined by one-way analysis of variance.Receiver operating characteristic analysis demonstrated high diagnostic performance of IOC in the diagnosis of cirrhosis.CONCLUSION:IOC is a very simple and reliable index for assessing liver functional reserve,which may prove to be useful in combination with the indocyanine green test for preoperative assessment of hepatic resection.展开更多
目的探讨13C-嘧噻西叮呼气试验用于肝脏储备功能检测的临床价值。方法将69例肝硬化患者分为Child A、B、C三组,另设7例为对照组。采集受试者不同时间点的呼气标本并检测13C丰度,绘制丰度(delta over baseline,DOB)曲线、代谢速率(metabo...目的探讨13C-嘧噻西叮呼气试验用于肝脏储备功能检测的临床价值。方法将69例肝硬化患者分为Child A、B、C三组,另设7例为对照组。采集受试者不同时间点的呼气标本并检测13C丰度,绘制丰度(delta over baseline,DOB)曲线、代谢速率(metabolisation velocity,MV)曲线和累积丰度(cumulated dose,CUM)曲线。结果随着Child-Pugh分级的升高,DOB、MV峰值出现时间延长,峰值降低(P<0.05),CUM曲线趋于低平;参数与部分常规肝功能检查呈相关性(P<0.05)。结论13C-嘧噻西叮呼气试验能够有效地反映肝细胞损伤情况和肝脏储备功能。展开更多
基金Supported by Health and Family Planning Commission of Zhejiang Province in China(partly)
文摘AIM: To investigate the value of magnetic resonance elastography(MRE) with regard to assessing liver functional reserve.METHODS: Data from inpatients diagnosed with a liver tumor at an interventional radiology department from July 2013 to June 2014 were analyzed. A 3.0 Tesla magnetic resonance unit was used to scan 32 patients with confirmed diagnoses of hepatocellular carcinoma(HCC); an MRE sequence was added to the protocol, and the data were reconstructed and analyzed by two attending radiologists. Regions of interest were identified in different slices of the non-tumor liver parenchyma to measure average stiffness. In addition, the indocyanine green(ICG) test was performed no more than 1 wk before or after the magnetic resonance examination for all 32 patients; the ICG retention rate at 15 min(ICGR-15) and the ICG plasma clearance rate(ICG-K) were recorded. Correlational analyses were performed between the liver stiffness values and the ICGR-15 as well as between the liver stiffness values and the ICG-K.RESULTS: Magnetic resonance imaging, including an MRE sequence and the ICG test, was performed successfully in all 32 enrolled patients. None of the patients developed complications. The mean ± SD of the elasticity values measured by the two attending radiologists were 4.7 ± 2.2 k Pa and 4.7 ± 2.1 k Pa, respectively. The average liver stiffness value of the non-tumor parenchyma measured using MRE in HCC patients was 4.7 ± 2.2 k Pa. The average ICGR-15 was 0.089 ± 0.077, and the average ICG-K was 0.19 ± 0.07. We found that the liver stiffness value of the non-tumor parenchyma was significantly and positively related to the ICGR-15(r = 0.746, P < 0.01) as well as significantly and negatively related to the ICG-K(r =-0.599, P < 0.01). The ICGR-15 was significantly and negatively related to the ICG-K(r =-0.852, P < 0.01).CONCLUSION: MRE is accurate and non-invasive; furthermore, it can be used to effectively assess the liver functional reserve of HCC patients.
文摘AIM:To investigate the clinical usefulness of a newly developed index,the "index of convexity(IOC)",for evaluating liver functional reserve using technetium99m-diethylenetriaminepentaacetic acid-galactosylhuman serum albumin(Tc-GSA scintigraphy).METHODS:In total,349 patients underwent Tc-GSA scintigraphy.Dynamic planner images were obtained,and time activity curves of the liver and heart were generated and analyzed.Our focus was on the convex shape of the liver accumulation curve.We developed a method for evaluating the extent of convexity and calculated an index that we named the IOC.Clearance index and receptor index were also calculated.The correlations between each GSA index with other liver function tests and liver histopathology were evaluated.RESULTS:Among the 3 indices generated by TcGSA,the IOC had the highest correlation with all other liver function tests(indocyanine green R15,albumin,prothrombin time,cholinesterase level,platelet count,and total bilirubin level).IOC can also differentiate between normal liver,chronic hepatitis,and liver cirrhosis with highest F ratio among GSA indices as determined by one-way analysis of variance.Receiver operating characteristic analysis demonstrated high diagnostic performance of IOC in the diagnosis of cirrhosis.CONCLUSION:IOC is a very simple and reliable index for assessing liver functional reserve,which may prove to be useful in combination with the indocyanine green test for preoperative assessment of hepatic resection.
