The value of Gd-EOB-DTPA-enhanced MRI in patients with major resection of liver cancer
10.3760/cma.j.cn112139-20200709-00550
- VernacularTitle:钆塞酸二钠增强MRI在肝癌大块肝切除手术中的应用价值
- Author:
Chen YE
1
;
Siqian REN
;
Sadula ABUDUHAIBAIER
;
Xin GUO
;
Meng YUAN
;
Chunhui YUAN
;
Dianrong XIU
Author Information
1. 北京大学第三医院普通外科 100191
- Keywords:
Liver neoplasms;
Hepatectomy;
Gd-EOB-DTPA-enhanced MRI;
Major resection;
Post-hepatoectmoy liver failure
- From:
Chinese Journal of Surgery
2020;58(10):765-769
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the value of Gd-EOB-DTPA-enhanced MRI in evaluating liver function and predicting the risk of post-hepatoectomy liver failure in patients with major resection of liver cancer.Methods:A total number of 212 patients were included from June 2016 to June 2019 at Department of General Surgery, Peking University Third Hospital with a retrospectively collected data.All patients underwent Gd-EOB-DTPA-enhanced MRI for diagnosis and preoperative evaluation of liver function.There were 135 males and 77 females, with age of (63.1±10.3) years old (range: 18 to 86 years old) . Relative enhancement ratio (RER) of the region of interest on Gd-EOB-DTPA-enhanced MRI was acquired by two independent researcher and then conducted the comparison of RER among the patients with or without post-hepatoectomy liver failure (PHLF) .Preoperative evaluation demonstrated that 141 cases infected by hepatitis virus, 128 cases with hepatitis B alone and 11 cases with hepatitis C alone, 2 cases had both of hepatitis B and C, and all patients were grade A judged by Child-Pugh score. The relationship between RER and PHLF was evaluated by Pearson correlation analysis and the diagnostic value of RER in predicting PHLF was test by receiver operating characteristic curve.Results:PHLF occurred in 42 patients according to ISGLS standard. Among them, 31 cases had level A liver failure, 9 cases had level B liver failure and 2 had level C failure. There was a significant correlation between RER and overall level of PHLF and RER was also significantly associated with severe B to C level of PHLF ( P<0.05) .The further receiver operating characteristics curve analysis showed that the diagnostic accuracy of RER on overall PHLF was 0.818 (sensitivity 72.9%, specificity 83.3%, cut-off value 73.5%, 95 %CI: 0.75 to 0.887) and on severe PHLF was 0.924 (sensitivity 97.0%, specificity 90.9%, cut-off value: 61.5%, 95 %CI: 0.79 to 0.90) . Conclusion:For patients who planned to undergo major resection of liver cancer, preoperative Gd-EOB-DTPA-enhanced MRI can help with the assessment of liver function and predicting the risk for post-hepatectomy liver failure.
