Value of gadoxetic acid-enhanced MR imaging for preoperative prediction of future liver regeneration after hemihepatectomy
Value of gadoxetic acid-enhanced MR imaging for preoperative prediction of future liver regeneration after hemihepatectomy
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DOI：
10.1007/s11604-024-01629-w
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发表时间：
2024-08-16
影响因子：
2.1
通讯作者：
Ishigami，Kousei
中科院分区：
文献类型：
--
作者：
Fujita，Nobuhiro;Ushijima，Yasuhiro;Ishigami，Kousei
目的肝切除术是目前治疗肝癌最有效的方法。据我们所知，还没有研究探讨钆塞酸增强磁共振成像（MRI）结果与接受半肝切除术患者的肝再生之间的关系。我们的目的是澄清钆塞酸增强MRI的肝实质的信号强度（SI）之间的关系和肝再生的程度在病人谁接受hemifepatectomy.Materials和methodsForty 1例患者接受钆塞酸增强MRI半肝切除术前入组。我们计算了肝胆期和增强前图像中肝脏与竖脊肌的SI比值（LMR）。使用以下公式计算ΔLMR：ΔLMR =（肝胆期LMR-造影前图像LMR）/造影前图像LMR。采用CT容积法计算术前和术后残肝体积（LV）。我们使用以下公式计算切除率（RR）和肝再生指数（LRI）：RR =切除的LV/总LV × 100，LRI =（术后残余LV−术前残余LV）/术前残余LV × 100。结果单因素分析显示RR和ΔLMR与LRI呈正相关（分别为ρ = 0. 4133，p = 0. 0072和ρ = 0. 7773，p <0. 001）。脾脏体积与LRI呈负相关（ρ =-0.3138，p = 0.0486）。多元逐步回归分析显示ΔLMR和RR与LRI独立相关（β系数分别为44.8771，p = 0.0198和1.9653，p < 0.001）。
PurposeLiver resection is currently considered the most effective treatment for patients with liver cancer. To the best of our knowledge, no study has investigated the association between gadoxetic acid-enhanced magnetic resonance imaging (MRI) findings and liver regeneration in patients who underwent hemihepatectomy. We aimed to clarify the relationship between the signal intensity (SI) of the liver parenchyma on gadoxetic acid-enhanced MRI and the degree of liver regeneration in patients who underwent hemihepatectomy.Materials and methodsForty-one patients who underwent gadoxetic acid-enhanced MRI before hemihepatectomy were enrolled. We calculated the liver-to-erector spinae muscle SI ratio (LMR) in the hepatobiliary phase and the precontrast images. ΔLMR was calculated using the following equation: ΔLMR = (LMR in the hepatobiliary phase−LMR in the precontrast image)/LMR in the precontrast image. The preoperative and postoperative remnant liver volumes (LVs) were calculated using CT volumetry. We calculated the resection rate (RR) and liver regeneration index (LRI) using the following formulas: RR = Resected LV/Total LV × 100 and LRI = (postoperative remnant LV−preoperative remnant LV)/preoperative remnant LV × 100. The relationships among LRI, imaging, and clinicopathological factors were analyzed.ResultsUnivariate analysis showed RR and ΔLMR showed a positive correlation with LRI (ρ = 0.4133, p = 0.0072 and ρ = 0.7773, p < 0.001, respectively). Spleen volume showed a negative correlation with LRI (ρ = −0.3138, p = 0.0486). Stepwise multiple regression analysis showed ΔLMR and RR were independently correlated with LRI (β coefficient = 44.8771, p = 0.0198 and β coefficient = 1.9653, p < 0.001, respectively).ConclusionΔLMR may serve as a preoperative predictor of liver regeneration in patients undergoing hemihepatectomy.