Periportal lymphatic system on post-hepatobiliary phase Gd-EOB-DTPA-enhanced MR imaging in normal subjects and patients with chronic hepatitis C
Periportal lymphatic system on post-hepatobiliary phase Gd-EOB-DTPA-enhanced MR imaging in normal subjects and patients with chronic hepatitis C
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DOI：
10.1007/s00261-017-1155-y
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发表时间：
2017-04
影响因子：
2.4
通讯作者：
Yasunari Yamada;S. Matsumoto;H. Mori;R. Takaji;M. Kiyonaga;N. Hijiya;Rika Tanoue;Kenichiro Tomonari;S. Tanoue;N. Hongo;M. Ohta;M. Seike;M. Inomata;K. Murakami;M. Moriyama
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文献类型：
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作者：
Yasunari Yamada;S. Matsumoto;H. Mori;R. Takaji;M. Kiyonaga;N. Hijiya;Rika Tanoue;Kenichiro Tomonari;S. Tanoue;N. Hongo;M. Ohta;M. Seike;M. Inomata;K. Murakami;M. Moriyama
目的：探讨门静脉周围淋巴结的显像方法使用脂肪抑制T2加权序列和三维（3D）容积各向同性快速自旋回波采集（VISTA）的Gd-EOB-DTPA增强磁共振（MR）图像上的（淋巴系统）在3.0 T正常人和慢性丙型肝炎患者中。方法2013年6月至2016年5月期间对254名受试者进行MR成像。在应用纳入和排除标准后，最终人群为31名正常受试者和34名慢性丙型肝炎患者。在静脉注射Gd-EOB-DTPA后的肝胆期后采集图像，这会导致胆管中的信号丢失，以促进门静脉周围淋巴系统的可视化。两名放射科医师评估了31名正常受试者门静脉周围淋巴系统的可视化。应用Mann-WhitneyU检验法测量了正常人门静脉周围淋巴系统的轴向直径，并与34例慢性丙型肝炎患者进行了比较，同时分析了其与肝纤维化标志物纤维化-4（FIB-4）的相关性。采用斯皮尔曼等级相关检验进行评估。结果门静脉周围淋巴系统被检测为高信号区周围的门静脉高达第三支由每个读者在所有正常的科目。慢性丙型肝炎患者门静脉周围主要淋巴系统的轴向尺寸明显大于正常人（p< 0.0001），并与FIB-4评分呈显著正相关（ρ= 0.73，结论Gd-EOB-DTPA肝胆期后采集的3D-VISTA脂肪抑制T2加权MR成像，增强显像可作为门静脉周围淋巴系统及肝纤维化程度的无创性检查方法。
PurposeWe sought to evaluate visualization of periportal lymphatics and lymph nodes (lymphatic system) on Gd-EOB-DTPA-enhanced magnetic resonance (MR) images using a fat-suppressed T2-weighted sequence with 3-dimensional (3D) volume isotropic turbo spin echo acquisition (VISTA) at 3.0 T in normal subjects and patients with chronic hepatitis C.MethodsMR imaging was performed in 254 subjects between June 2013 and May 2016. After applying inclusion and exclusion criteria, the final population was 31 normal subjects and 34 patients with chronic hepatitis C. Images were acquired after the hepatobiliary phase following intravenous administration of Gd-EOB-DTPA, which causes signal loss in the bile ducts, to facilitate the visualization of the periportal lymphatic system. Two radiologists assessed the visualization of the periportal lymphatic system in 31 normal subjects. The axial dimensions of the main periportal lymphatic system in normal subjects were measured and compared with those of 34 patients with chronic hepatitis C using the Mann–WhitneyU-test, and their correlation with a hepatic fibrosis marker, the Fibrosis-4 (FIB-4), was assessed using Spearman’s rank correlation test.ResultsThe periportal lymphatic system was detected as high signal intensity areas surrounding the portal vein up to the third branches by each reader in all normal subjects. The axial dimensions of the main periportal lymphatic system in patients with chronic hepatitis C were significantly larger than those in normal subjects (p< 0.0001), and showed a significantly positive correlation with the FIB-4 score (ρ= 0.73,p< 0.001).ConclusionsFat-suppressed T2-weighted MR imaging with 3D-VISTA acquired after the hepatobiliary phase on Gd-EOB-DTPA-enhanced imaging may be a useful noninvasive method for evaluating the periportal lymphatic system and the degree of hepatic fibrosis.