Feasibility Study Of MRI IDEAL-IQ Sequence In Evaluating Liver Function Of Patients With Liver Cirrhosis

Objective:To investigate the feasibility of assessing the liver function grading by IDEAL-IQ on 1.5T MR.Methods:A retrospective analysis of the 1.5T MR IDEAL-IQ sequence scan from February 2016 to December 2018 was performed in our hospital,and the patients were clinically diagnosed with live cirrhosis,which were divided into A,B and C grades according to child-pugh grading standard of liver function.The results of liver function related tests were recorded(total bilirubin,albumin,prothrombin time,prealbumin,alanine aminotransferase,aspartate aminotransferase,total bile acid,-glutamyl transpeptidase,alkaline phosphatase).Out-of-group standard:a,the sampling time of clinical test data is incomplete or the sampling time of laboratory examination is more than 3 days different from that of MRI examination.b,liver postoperative patients.c,intrahepatic occupying disease.d,gastrointestinal hemorrhage,recent history of blood transfusion or hemochromatosis.Final group:53Child-Pugh A,37 Child-Pugh B,21 Child-Pugh C.Fat ratio image,R2~*relaxation rate image were used to measure fat fraction and R2~*value of liver by two doctors(3years and 2 years respectively)on AW4.6 workstation.The mean value of liver data was calculated.The fat fraction and R2~*value of the three groups were compared by Kruskal-Wallis H.The group A and B were combined and compared with the group C by Mann-Whitney U.The combined fat fraction and R2~*value were used to establish the predictive model of the group C by binary logistics regression analysis,and the receiver operating characteristic was drawn to obtained the area under curve(AUC),then the sensitivity and the specificity were calculated with the optimal threshold.Pearson correlation coefficient was used to test the correlation between fat fraction,R2~*value and the results of various serological tests.Results:Two times of measurement data have good consistency(ICC>0.8).The liver fat fraction and R2~*increased with the decrease of liver function.Fat fraction of Child-Pugh A,B and C groups were respectively(3.31±0.56)%,(4.25±1.62)%and(7.35±4.31)%.R2~*value of Child-Pugh A,B and C groups were(28.62±5.23)Hz,(33.44±10.21)Hz and(51.97±24.76)Hz,respectively.There were significant differences in fat fraction and R2~*value between the three groups.The AUC of combined fat fractiong and R2~*value in the diagnosis of Child-Pugh C was 0.938.The sensitivity and the specificity were 91.1%and 95.2%.Fat fraction was positively correlated with total bilirubin,total bile acid,gamma glutamyl transpeptidase and prothrombin time,negatively correlated with albumin(P<0.05).R2~*value was positively correlated with total bilirubin and prothrombin time,negatively correlated with albumin and prealbumin(P<0.05).Conclution:The 1.5T MRI IDEAL-IQ sequence can be used to evaluate the liver reserve function of patients with liver cirrhosis by fat fraction and R2~*value,especially for the diagnosis of Child-Pugh C cirrhosis patients with high sensitivity and specificity.