钆塞酸二钠增强磁共振成像T1-mapping评估肝纤维化评分的研究

doi:10.19871/j.cnki.xfcrbzz.2020.03.008

摘要/Abstract

摘要： 目的探讨钆塞酸二钠增强磁共振成像T1-mapping对肝脏纤维化评分的诊断价值。方法选择149例肝切除术的患者,术前均完成钆塞酸二钠增强磁共振成像T1-mapping扫描,获得病灶周围肝组织增强前及增强后5、10、15min肝脏T1弛豫时间及病灶周围肝组织ishak纤维化评分。统计学分析不同纤维化评分间T1弛豫时间的差异,以及T1-mapping值对肝纤维化严重程度的诊断能力。结果各期扫描中,不同纤维化评分患者T1弛豫时间的差异均有统计学意义,其中,增强后15minT1弛豫时间差异最大,0分比5分（P=0.007）、0分比6分（P<0.001）、1分比6分（P=0.001）、2分比6分（P=0.002）及3分比6分（P=0.008）患者差异有统计学意义。使用ROC曲线评价T1弛豫时间对患者肝纤维化严重程度的诊断能力,增强后15min T1-mapping扫描的T1弛豫时间具有最大的曲线下面积,其对于纤维化评分>0分、>1分、>2分、>3分、>4分及>5分的患者的ROC曲线下面积分别为0.727、0.736、0.697、0.708、0.703及0.720。结论使用T1弛豫时间对患者纤维化严重程度进行评估具有一定的价值,增强后15min的T1弛豫时间具有最佳的诊断效能。

关键词: 钆塞酸二钠, 肝纤维化, T1弛豫时间, 磁共振成像

Abstract: Objective To investigate the diagnostic value of Gd-EOB-DTPA enhanced MRI T1-mapping in grading the severity of liver fibrosis. Methods A total 149 patients who have underwent Gd-EOB-DTPA enhanced MRI T1-mapping scans and then hepatectomy were enrolled. T1 relaxation time before and 5, 10, and 15 minutes after bolus of contrast agent and ishak fibrosis score of Liver tissue surrounding the lesion were obtained. The differences in T1 relaxation time between cases with different fibrosis scores and the diagnostic ability to use T1 relaxation time to grade the severity of liver fibrosis were statistically analyzed. Results The differences in T1 relaxation time among patients with different fibrosis scores were statistically significant in each phase of the scan. Among them, the difference in T1 relaxation time was the largest at 15 min after enhancement. After pairwise comparison, there were statistically significant differences between groups 0 and 5 (P=0.007), group 0 and 6 (P<0.001), group 1 and 6 (P=0.001), group 2 and 6 (P=0.002), and group 3 and 6 (P=0.008). Using ROC curve analysis, T1 relaxation time obtained from T1-mapping acquired 15-minute after enhancement outperformed others with largest area under the curve, specifically in which the area under the ROC curve for patients with fibrosis score >0, >1, >2, >3, >4 and >5 were 0.727, 0.736, 0.697, 0.708, 0.703, and 0.720, respectively. Conclusion T1 relaxation time can be used to evaluate the severity of fibrosis in patients, and particularly, the T1 relaxation time of 15 minutes after enhancement has the best diagnostic efficacy.

Key words: Gadoxetic acid disodium injection, Liver fibrosis, T1 relaxation time, Magnetic resonance imaging

周忠洋, 向颜韩, 廖锦元. 钆塞酸二钠增强磁共振成像T1-mapping评估肝纤维化评分的研究[J]. 新发传染病电子杂志, 2020, 5(3): 178-182.

Zhou Zhongyang, Xiang Yanhan, Liao Jinyuan. Liver fibrosis score assessed by GD-EOB-DTPA enhanced MRI T1-mapping[J]. Electronic Journal of Emerging Infectious Diseases, 2020, 5(3): 178-182.

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