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山东大学学报 (医学版) ›› 2024, Vol. 62 ›› Issue (4): 31-39.doi: 10.6040/j.issn.1671-7554.0.2024.0030

• 临床医学 • 上一篇    

EOB-MRI多定量参数对肝胆期乏血供低信号结节进展风险的评估价值

刘小文1,2,曹永泉3,侯明源1,4,于德新1   

  1. 1.山东大学齐鲁医院放射科, 山东 济南 250012;2.山东第一医科大学附属内分泌与代谢病医院影像科, 山东 济南 250000;3.淄博第一医院放射科, 山东 淄博 255299;4.威海市妇幼保健院放射科, 山东 威海 264299
  • 发布日期:2024-05-16
  • 通讯作者: 于德新. E-mail:yudexin0330@sina.com

Value of multiple quantitative parameters of EOB-MRI in the risk assessment of progression of HHN in hepatobiliary phase

LIU Xiaowen1,2, CAO Yongquan3, HOU Mingyuan1,4, YU Dexin1   

  1. 1. Department of Radiology, Qilu Hospital, Cheeloo College of Medicine, Shandong University, Jinan 250012, Shandong, China;
    2. Department of Radiology, Endocrine and Metabolic Diseases Hospital of Shandong First Medical University, Jinan 250000, Shandong, China;
    3. Department of Radiololgy, Zibo First Hospital, Zibo 255299, Shandong, China;
    4. Department of Radiololgy, Maternal and Child Health Hospital of Weihai, Weihai 264299, Shandong, China
  • Published:2024-05-16

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摘要： 目的 探讨钆塞酸二钠(gadolinium-ethoxybenzyl-diethylenetriamine-pentaacetic, Gd-EOB-DTPA, 简称EOB)增强MRI多定量参数在肝胆期(hepatobiliary phase, HBP)乏血供低信号结节(hypovascular hypointense nodules, HHN)进展风险预测中的价值。 方法 选取在山东大学齐鲁医院经钆塞酸二钠增强MRI(EOB enhanced MRI,EOB-MRI)检查并出现肝胆期HHN的患者作为研究对象,通过随访分为稳定组与不稳定组,观察病灶基线及随访中的影像特点,在基线影像上测量并计算相关参数。比较两组HHN之间各基线定量参数的差异,受试者工作特征曲线(receiver operating characteristic curve, ROC)分析各定量参数对结节稳定性的预测效能,二元Logistic回归模型分析肝胆期HHN进展的风险因子。 结果 T2WI信号平均值,T2WI及肝胆期的对比噪声比(contrast-to-noise ratio, CNR)CNRT2WI、CNRHBP,肝胆期对比率(contrast ratio, CR)CRHBP,肝胆期HHN强化率在两组之间的差异均有统计学意义(P=0.045, P=0.037, P=0.043, P=0.049, P=0.003),表观弥散系数(apparent diffusion coefficient, ADC)值及CRADC在两组之间的差异均有统计学意义(P<0.001, P=0.001)。ROC曲线分析显示,肝胆期强化率、ADC值及CRADC对评价HHN稳定性具有良好的预测效能,敏感度分别为72.2%、96.9%、87.5%,特异性分别为72.7%、54.5%、63.6%。扩散加权成像(diffusion weighted imaging, DWI)高信号、肝胆期强化率是肝胆期HHN进展的预测因子。 结论 EOB增强MRI多定量参数的肝胆期强化率、ADC值及CRADC有助于对肝胆期HHN进行危险度分层。

关键词: 肝胆期乏血供低信号结节, 钆塞酸二钠, 磁共振成像, 定量参数

Abstract: Objective To explore the value of multiple quantitative parameters of gadoxetic acid(gadolinium-ethoxybenzyl-diethylenetriamine-pentaacetic(Gd-EOB-DTPA, abbreviated as EOB)enhanced MRI in predicting the risk of progression of hypovascular hypointense nodules(HHN)in hepatobiliary phase(HBP). Methods Patients with HHNs in hepatobiliary phase examined by EOB enhanced MRI(EOB-MRI)in Qilu Hospital of Shandong University were divided into stable group and unstable group through follow-up. The baseline and imaging characteristics of the lesions were observed, and some parameters were measured and calculated. The differences of baseline quantitative parameters between the two groups of HHN were compared. Receiver operating characteristic(ROC)curve was used to analyze the predictive efficiency of each quantitative parameter on nodular stability. Binary Logistic regression was used to analyze the risk factors for the progression of HHN in hepatobiliary phase. Results There were significant differences in the mean value of T2WI signal, contrast-to-noise ratio(CNR)at T2WI and hepatobiliary phase(CNRT2WI, CNRHBP), contrast ratio at hepatobiliary phase(CRHBP)and hepatobiliary phase enhancement rate between the two groups(P=0.045, P=0.037, P=0.043, P=0.049, P=0.003). There were significant differences in apparent diffusion coefficient(ADC)value and CRADC between the two groups(P<0.001, P=0.001). ROC curve analysis showed that hepatobiliary phase enhancement rate, ADC value and CRADC had good predictive power for evaluating HHN stability, with sensitivities of 72.2%, 96.9%, 87.5% and specificities of 72.7%, 54.5% and 63.6%, respectively. High signal intensity on diffusion-weighted imaging(DWI)and the enhancement rate of HHN in hepatobiliary phase were predictors of the progression of HHN in hepatobiliary phase. Conclusion The hepatobiliary phase enhancement rate, ADC value and CRADC of EOB-MRI multi-quantitative parameters are helpful for the risk stratification of HHN in hepatobiliary phase.

Key words: Hypovascular hypointense nodules in hepatobiliary phase, Gadolinium-ethoxybenzyl-diethylenetriamine-pentaacetic, Magnetic resonance imaging, Quantitative parameter

中图分类号: 

  • R575
[1] Sciarra A, Di Tommaso L, Nakano M, et al. Morphophenotypic changes in human multistep hepatocarcinogenesis with translational implications[J]. J Hepatol, 2016, 64(1): 87-93.
[2] Omata M, Cheng AL, Kokudo N, et al. Asia-Pacific clinical practice guidelines on the management of hepatocellular carcinoma: a 2017 update[J]. Hepatol Int, 2017, 11(4): 317-370.
[3] 杨日辉,郭剑波,范伟雄,等. 钆塞酸二钠增强MRI特征对肝细胞癌微血管侵犯的预测价值[J]. 国际医学放射学杂志, 2022, 45(4): 396-400. YANG Rihui, GUO Jianbo, FAN Weixiong, et al. Predicting microvascular invasion of hepatocellular carcinoma based on Gd -EOB -DTPA enhanced MRI features[J]. International Journal of Medical Radiology, 2022, 45(4): 396-400.
[4] Joo I, Kim SY, Kang TW, et al. Radiologic-pathologic correlation of hepatobiliary phase hypointense nodules without arterial phase hyperenhancement at gadoxetic acid-enhanced MRI: a multicenter study[J]. Radiology, 2020, 296(2): 335-345.
[5] Li Y, Chen J, Weng S, et al. Hepatobiliary phase hypointensity on gadobenate dimeglumine-enhanced magnetic resonance imaging may improve the diagnosis of hepatocellular carcinoma[J]. Ann Transl Med, 2021, 9(1): 55.
[6] 王帅,吴明,徐中阳. 钆塞酸二钠磁共振增强成像在鉴别肝硬化结节与小肝癌中的应用[J]. 影像研究与医学应用,2021, 5(21): 54-55.
[7] Kudo M, Kawamura Y, Hasegawa K, et al. Management of hepatocellular carcinoma in Japan: JSH consensus statements and recommendations 2021 update[J]. Liver Cancer, 2021, 10(3): 181-223.
[8] Park HJ, Choi BI, Lee ES, et al. How to differentiate borderline hepatic nodules in hepatocarcinogenesis: emphasis on imaging diagnosis[J]. Liver Cancer, 2017, 6(3): 189-203.
[9] Suh CH, Kim KW, Pyo J, et al. Hypervascular transformation of hypovascular hypointense nodules in the hepatobiliary phase of gadoxetic acid-enhanced MRI: a systematic review and meta-analysis[J]. AJR Am J Roentgenol, 2017, 209(4): 781-789.
[10] Choi BI, Lee JM, Kim TK, et al. Diagnosing borderline hepatic nodules in hepatocarcinogenesis: imaging performance[J]. AJR Am J Roentgenol, 2015, 205(1): 10-21.
[11] Saitoh T, Sato S, Yazaki T, et al. Progression of hepatic hypovascular nodules with hypointensity in the hepatobiliary phase of Gd-EOB-DTPA-enhanced MRI in hepatocellular carcinoma cases[J]. Intern Med, 2018, 57(2): 165-171.
[12] 任涛,谢双双,黄黎香,等. Gd-EOB-DTPA增强MRI与超声造影对小肝癌诊断价值的对比分析[J]. 实用放射学杂志, 2018, 34(5): 690-693. REN Tao, XIE Shuangshuang, HUANG Lixiang, et al. Diagnostic value of Gd-EOB-DTPA enhanced MRI compared with contrast-enhanced ultrasound for small hepatocellular carcinoma[J]. Journal Practical Radiology, 2018, 34(5): 690-693.
[13] Van Beers BE, Pastor CM, Hussain HK. Primovist, eovist: what to expect?[J]. J Hepatol, 2012, 57(2): 421-429.
[14] Kitao A, Matsui O, Yoneda N, et al. The uptake transporter OATP8 expression decreases during multistep hepatocarcinogenesis: correlation with gadoxetic acid enhanced MR imaging[J]. Eur Radiol, 2011, 21(10): 2056-2066.
[15] Haimerl M,Utpatel K,Gotz A,et al. Quantification of contrast agent uptake in the hepatobiliary phase helps to differentiate hepatocellular carcinoma grade[J]. Sci Rep, 2021, 11(1): 22991. doi: 10.1038/s41598-021-02499-2.
[16] 黄钰莹,陈奕杰,郝树,等. 钆塞酸二钠增强磁共振成像在肝脏局灶性病变诊断及评估肝细胞癌病理分化程度的价值研究[J]. 中国医学装备, 2023, 20(9): 41-45. HUANG Yuying, CHEN Yijie, HAO Shu, et al. Study on the value of MRI-enhanced with gadoxetate disodium in diagnosing focal liver lesions and evaluating HCC pathological differentiation degree[J]. China Medical Equipment, 2023, 20(9): 41-45.
[17] 焦琳琳,段崇锋,于海洋,等. 钆塞酸二钠增强MRI定量及定性评价肝癌微血管侵犯的价值[J]. 放射学实践, 2021, 36(8): 1026-1031. JIAO Linlin, DUAN Chongfeng, YU Haiyang, et al. The value of gadolinium-ethoxybenzyl-diethylenetriamine pentaacetic acid enhanced MRI quantitatively and qualitatively predicting hepatocellular carcinoma microvascular invasion[J]. Radiol Practice, 2021, 36(8): 1026-1031.
[18] Jin YJ, Cho SG, Lee KY, et al. Association between relative liver enhancement on gadoxetic acid enhanced magnetic resonance images and histologic grade of hepatocellular carcinoma[J]. Medicine(Baltimore), 2017, 96(30): e7580. doi: 10.1097/MD.0000000000007580.
[19] Tong HF, Liang HB, Mo ZK, et al. Quantitative analysis of gadoxetic acid-enhanced magnetic resonance imaging predicts histological grade of hepatocellular carcinoma[J]. Clin Imaging,2017, 43: 9-14. doi: 10.1016/j.clinimag.2016.12.009.
[20] Xu PJ, Yan FH, Wang JH, et al. Contribution of diffusion-weighted magnetic resonance imaging in the characterization of hepatocellular carcinomas and dysplastic nodules in cirrhotic liver[J]. J Comput Assist Tomogr,2010, 34(4): 506-512.
[21] Xu H, Li X, Xie J X, et al. Diffusion-weighted magnetic resonance imaging of focal hepatic nodules in an experimental hepatocellular carcinoma rat model[J]. Acad Radiol,2007, 14(3): 279-286.
[22] 王德顺. 应用定量扩散加权MRI预测肝细胞癌组织学分级的临床价值[J]. 全科医学临床与教育,2021, 19(1): 62-64. WANG Deshun. Clinical value of quantitative diffusion weighted MRI in predicting histological grade of hepatocellular carcinoma[J]. Clinical Education of General Practice, 2021, 19(1): 62-64.
[23] Kogita S, Imai Y, Okada M, et al. Gd-EOB-DTPA-enhanced magnetic resonance images of hepatocellular carcinoma: correlation with histological grading and portal blood flow[J]. Eur Radiol, 2010, 20(10): 2405-2413.
[24] Cho YK, Kim JW, Kim MY, et al. Non-hypervascular hypointense nodules on hepatocyte phase gadoxetic acid-enhanced MR images: transformation of MR hepatobiliary hypointense nodules into hypervascular hepatocellular carcinomas[J]. Gut Liver, 2018, 12(1): 79-85.
[25] Kim YS, Song JS, Lee HK, et al. Hypovascular hypointense nodules on hepatobiliary phase without T2 hyperintensity on gadoxetic acid-enhanced MR images in patients with chronic liver disease: long-term outcomes and risk factors for hypervascular transformation[J]. Eur Radiol,2016, 26(10): 3728-3736.
[26] Yang HJ, Song JS, Choi EJ, et al. Hypovascular hypointense nodules in hepatobiliary phase without T2 hyperintensity: long-term outcomes and added value of DWI in predicting hypervascular transformation[J]. Clin Imaging, 2018, 50: 123-129. doi: 10.1016/j.clinimag.2018.01.003.
[27] Cho YK, Kim JW, Kim MY, et al. Non-hypervascular hypointense nodules on hepatocyte phase gadoxetic acid-enhanced MR Images: transformation of mr hepatobiliary hypointense nodules into hypervascular hepatocellular carcinomas[J]. Gut Liver, 2018, 12(1): 79-85.
[28] Hyodo T, Murakami T, Imai Y, et al. Hypovascular nodules in patients with chronic liver disease: risk factors for development of hypervascular hepatocellular carcinoma[J]. Radiology, 2013, 266(2): 480-490.
[29] Joishi D, Ueno A, Tanimoto A, et al. Natural course of hypovascular nodules detected on gadoxetic acid-enhanced MR imaging: presence of fat is a risk factor for hypervascularization[J]. Magn Reson Med Sci, 2013, 12(4): 281-287.
[30] Saitoh T, Sato S, Yazaki T, et al. Progression of hepatic hypovascular nodules with hypointensity in the hepatobiliary phase of Gd-EOB-DTPA-enhanced MRI in hepatocellular carcinoma cases[J]. Intern Med, 2018, 57(2): 165-171.
[31] 李照,朱继业.《原发性肝癌诊疗指南(2022年版)》解读[J]. 临床肝胆病杂志, 2022, 38(2): 1027-1029.
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