| Purpose: To investigate the feasibility of dynamic contrast-enhanced magnetic resonance imaging with Gd-EOB-DTPA to evaluate liver function.Materials and Methods:From August 15,2020 to December 15,2022,the imaging and laboratory data of 196 patients who underwent gadoxetate disodium enhanced 3.0T magnetic resonance imaging in Shanghai East Hospital Affiliated to were retrospectively analyzed.A total of 196 patients underwent gadoxetate disodium enhanced magnetic resonance imaging to evaluate known or suspected focal liver lesions.According to the inclusion and exclusion criteria,61 patients were finally included,including 45 males and 16 females,with an average age of 57.44±11.48 years.According to the Child-Pugh classification,according to the liver function of the patients,34 patients with normal liver function were enrolled in group D(control group),18 patients with Child-Pugh grade A were enrolled in group A,and 5 patients with Child-Pugh grade B were enrolled in group B.A total of 4 patients with Child-Pugh grade C were enrolled in group C;Axial images of mid-upper abdominal gadolinium-ethoxybenzyl diethylenetriamine pentaacetic acid(GD-EOB-DTPA)enhanced MRI were acquired before and 10 and 20 minutes after contrast injection.The mean signal intensity of liver parenchyma(SI liver)and spleen(SI spleen)were obtained before and 10 minutes and 20 minutes after the injection of contrast medium.The mean signal intensity(SI)of the common bile duct was measured at 10 min,20 min and the renal pelvis at 20 min after the injection of contrast medium.The relative enhancement(RE)of liver parenchyma,liver-spleen signal intensity ratio(L/s)at 20 minutes after contrast enhancement,signal intensity of common bile duct(SI common bile duct),mean signal intensity of bilateral renal pelvis(SI renal pelvis),mean signal intensity of liver parenchyma at 10 minutes and 20 minutes after contrast injection and Child-pugh related biochemical indexes were measured and compared between groups Subject correlation analysis.Liver signal intensity(SI liver parenchyma)was measured using a region of interest(ROI)to calculate relative liver parenchyma enhancement(RE).To measure the signal intensity of liver parenchyma(SI liver parenchyma),ROI was set at two positions in the right lobe: the right anterior lobe(SI right anterior lobe),the right posterior lobe(SI right posterior lobe)and the left lobe(SI left liver lobe).SI liver parenchyma =(SI right anterior lobe + SI right posterior lobe + SI left liver lobe)/3.The signal intensity of liver parenchyma before contrast injection(SIpre)and after contrast injection(SIpost)was calculated as the mean of the three rois on T1-weighted images.RE was calculated as(SIpost-SIpre)/SIpre to assess liver parenchymal enhancement after contrast injection.The liver-to-spleen signal intensity ratio(L/s)was calculated as SI liver parenchyma /SI spleen after a 20-min delay in contrast injection.Results: After injection of gadoxetic acid disodium,there was Asignificant difference in SE among the control group D,A,B and C groups(F=3.4,P=0.024).There was a significant difference in liver-spleen signal intensity ratio(L/s)after 20 minutes delay among the four groups(F=8.339,P<0.05).There was a statistically significant difference in the overall mean of bile duct signal intensity after 10 and 20 minutes of delay(SI for common bile duct 10 min,SI for common bile duct 20min)(F=5.198,P=0.003;F=5.711,P=0.002).There was no significant difference in the mean signal intensity of the delayed renal pelvis(SI)at 20min(F=1.113,P=0.344).SI10 min and SI20 min were negatively correlated with serum total bilirubin and prothrombin time,and positively correlated with serum albumin.Conclusion: Gd-EOB-DTPA-enhanced MRI can evaluate liver function by assessing the relative enhancement of liver parenchyma,liver-spleen signal intensity ratio,and signal intensity of common bile duct.The degree of enhancement of liver parenchyma is affected by liver function,and there is a certain correlation between the degree of enhancement and the parameters of clinical evaluation of liver function. |
