3D T1 relaxometry pre and post gadoxetic acid injection for the assessment of liver cirrhosis and liver function
3D T1 relaxometry pre and post gadoxetic acid injection for the assessment of liver cirrhosis and liver function
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DOI：
10.1016/j.mri.2015.06.013
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发表时间：
2015-11-01
影响因子：
2.5
通讯作者：
Taouli, Bachir
中科院分区：
文献类型：
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作者：
Besa, Cecilia;Bane, Octavia;Taouli, Bachir
目的：与血液检查相比，评估钆塞酸注射前后3D双翻转角（DFA）T1标测技术在评估肝硬化和肝功能方面的诊断价值（APRI：天冬氨酸转氨酶与血小板比率指数）。共133例患者接受钆塞酸增强肝脏MRI，包括造影前和造影后20分钟的3D FLASH DFA-T1标测序列（肝胆期，HBP）纳入本项IRB批准的回顾性研究。在对比前和HBP期间测量肝实质中的T1值（毫秒），Delta T1（%）计算为[（T1前- T1后）/T1前] x 100。使用Mann-Whitney U检验比较了肝硬化和非肝硬化患者之间以及使用Child-Pugh和终末期肝脏疾病模型（MELD）评分分层的患者之间的T1和Delta T1值。结果：纳入50例非肝硬化和83例肝硬化患者[Child-Pugh A（n = 41），B（n = 31）和C（n = 11）]。造影前T1值在脑梗死患者和非脑梗死患者之间无显著差异。T1-HBP和Delta TI值在肝硬化患者（p < 0.0001）和MELD评分较高（>17）的患者中存在显著差异（p = 0.003）。AT 1与Child-Pugh和MELD评分呈显著强相关（分别为r = 0.7，p < 0.0001; r = 0.56，p < 0.001）。AUC相似（p = 0.9）检测肝硬化，观察T1 HBP（0.83），安（0.86）和APRI（0.85）;然而，与Delta T1相比，APRI显示出有限的灵敏度（55%）（74.7%）和T1 HBP（80.7%）。钆塞酸注射前后的三维DFA-T1成像序列对肝硬化的诊断和肝功能的评估有一定的价值。(C)2015 Elsevier Inc. All rights reserved.
Purpose: To assess the diagnostic value of a 3D dual-flip-angle (DFA) T1 mapping technique with whole liver coverage before and after gadoxetic acid injection for assessment of cirrhosis and liver function, compared to blood tests (APRI: aspartate aminotransferase-to-platelet ratio index).Materials and methods: A total of 133 patients who underwent gadoxetic acid-enhanced liver MRI including a 3D FLASH DFA-T1 mapping sequence before and 20 min post-contrast (hepatobiliary phase, HBP) were included in this retrospective IRB approved study. T1 values (msec) were measured on pre-contrast and during HBP in liver parenchyma, Delta T1 (%) was calculated as [(T1 pre - T1 post)/T1 pre] x 100. T1 and Delta T1 values were compared between cirrhotic and non-cirrhotic patients and between patients stratified using Child-Pugh and Model for End-Stage Liver Disease (MELD) scores using Mann-Whitney U test. Diagnostic performance of T1 mapping parameters vs. APRI for diagnosing cirrhosis and for assessing degree of liver dysfunction was evaluated using ROC analysis.Results: Fifty non-cirrhotic and 83 cirrhotic patients [Child-Pugh A (n = 41), B (n = 31) and C (n = 11)] were included. There was no significant difference in pre-contrast T1 values between cirrhotic and non-cirrhotic patients. T1-HBP and Delta TI values were significantly different in patients with cirrhosis (p < 0.0001) and higher MELD scores (>17) (p = 0.003). AT1 showed significant strong correlations with Child-Pugh and MELD scores (r = 0.7, p < 0.0001; r = 0.56, p < 0.001 respectively). Similar AUCs (p = 0.9) for detection of liver cirrhosis were observed for T1 HBP (0.83), An (0.86) and APRI (0.85); however APRI showed limited sensitivity (55%) in comparison with Delta T1 (74.7%) and T1 HBP (80.7%).Conclusion: 3D DFA-T1 mapping sequence used before and after gadoxetic acid injection is useful for the diagnosis of cirrhosis and for the assessment of liver function. (C) 2015 Elsevier Inc. All rights reserved.