Clin Gastroenterology H: 肝细胞特异性造影剂可以用于评估原发性硬化性胆管炎患者肝功能

2019-01-11 MedSci MedSci原创

核磁共振(MRI)可以有效的评估腹腔内部器官的形态学表现,因此,本项研究的目的是评估肝胆相磁共振成像(MRI)是否可以作为评估原发性硬化性胆管炎(PSC)患者肝细胞功能。

背景与目的
核磁共振(MRI)可以有效的评估腹腔内部器官的形态学表现,因此,本项研究的目的是评估肝胆相磁共振成像(MRI)是否可以作为评估原发性硬化性胆管炎(PSC)患者肝细胞功能。

方法
研究人员收集了从2012年3月至2016年3月间共111名患者(83名男性,28名女性)的临床医疗数据,所有患者均确诊为PSC,在肝细胞特异性造影剂(gadoxetate disodium)注射前后(肝胆相)接受MRI评估。在每个肝段中测量信号强度。计算平均相对增强值并与肝功能测试,预后评分系统(终末期肝病模型评分; Mayo风险评分; Amsterdam-Oxford-PSC评分),内镜逆行胰胆管造影术检测到异常的结果(使用阿姆斯特丹胆管造影分类系统)和临床终点(肝移植,胆管癌,肝脏相关死亡)之间的关联。

结果
大多数患者具有中等水平PSC的风险(MELD评分中位数为8,Mayo评分中位数为0.27)。21例患者达到临床终点(6例发生胆管癌,8例接受肝移植,7例死亡)。注射造影剂后20分钟,碱性磷酸酶水平(r = -0.636),胆红素(r = -0.646),白蛋白(r = 0.538)相对强化的相关性最高。国际标准化比率(r = 0.456); MELD评分(r = -0.587); 梅奥风险评分(r = -0.535)和阿姆斯特丹 - 牛津模型评分(r = -0.595)(P<.0001)也都与造影成像存在相关性。截止增强值0.65对于确定具有临床终点的患者具有73.9%的敏感性92.9%特异性。

结论
在111例PSC患者的分析中,研究人员发现使用肝细胞特异性造影剂可以观察到MRI测量的相对增强,MRI的特异性表现可以具有73.9%敏感性92.9%特异性来判断患者是否发生了PSC。

原始出处:

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    2019-02-04 xjy02
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  5. 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  6. 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time=2019-01-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1494097, encodeId=2bdd149409e0f, content=<a href='/topic/show?id=3e34949e333' target=_blank style='color:#2F92EE;'>#造影#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=24, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=94973, encryptionId=3e34949e333, topicName=造影)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=908d9134595, createdName=sodoo, createdTime=Sun Jan 13 10:18:00 CST 2019, time=2019-01-13, status=1, ipAttribution=)]
    2019-10-08 许安
  8. 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    2019-01-13 sodoo

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