Objective:To explore the value of hepatocyte fraction (HeF) based on gadolinium ethoxybenzyl diethylenetriaminepentaacetic acid (Gd-EOB-DTPA) enhanced liver MRI for evaluating liver function. Methods: A total of 82 patients with a history of chronic vira hepatitis B or suspected focal liver lesions underwent upper abdominal MRI were collected. The patients were divided into model for end-stage liver disease (MELD)≤10 group (n=61) and MELD>10 group (n=21) according to the MELD score of end-stage liver disease model. T1 mapping imaging was collected before and 20 minutes after Gd-EOB-DTPA administration, and parameters including precontrast and postcontrast T1 values of the liver (T1pre and T1post), the increase of T1 relaxation rate (ΔR1), the decrease rate of T1 relaxation time (ΔT1), HeF and K value were obtained and compared between 2 groups. For the parameters being statistically different between groups, multivariate Logistic regression was used to analyze the important predictors of liver function MELD>10. The correlations between each parameter and MELD score were analyzed, and the diagnostic efficacy of each parameter in differential diagnosis of patients with different liver function was evaluated by using ROC curve. Results: There were significant differences of all parameters but T1pre between 2 groups (all P<0.05). Regression analysis showed that K value was important predictive factor of MELD score >10 (P=0.01). Both T1pre and T1post were positively correlated with MELD score (r=0.46, 0.73, both P<0.01), while ΔT1, ΔR1, HeF and K value were negatively correlated with MELD score (r=-0.60, -0.52, -0.73, -0.49, all P<0.01). AUC of HeF, K value, T1post, ΔT1 and ΔR1 for identifying patients with different liver function was 0.77, 0.84, 0.75, 0.75 and 0.77 (all P=0.01), respectively. Conclusion: HeF and other parameters based on Gd-EOB-DTPA enhanced liver MRI could be used to evaluate liver function.

Objective To investigate the value of qualitative and quantitative characteristics of gadolinium ethoxybenzyl diethylenetriamine pentaacetic acid(Gd-EOB-DTPA)enhanced MRI in preoperative prediction of vessels encapsulating tumor clusters(VETC)pattern in hepatocellular carcinoma(HCC).Methods A total of 234 patients diagnosed with HCC by pathology were analyzed retrospectively.A total of 101 VETC-positive HCC patients and 133 VETC-negative HCC patients were included.All patients were divided into training group and validation group according to 7︰3.The training group data were used to construct a prediction model for VETC-positive HCC.Receiver operating characteristic(ROC)curve was drawn and the area under the curve(AUC)was calculated to verify the diagnostic efficiency of the model.Calibration curve was drawn to verify the calibration of the model.Results Multivariate logistic regression analysis predicted the independent risk factors for VETC-positive HCC:portal phase peripheral washout[odds ratio(OR)6.493],necrosis or severe ischemia(OR 4.756),targetoid transitional phase or hepatobiliary phase(OR 0.307),and lesion to liver signal intensity ratio(LLR)on arterial phase(OR 0.074).The AUC of the training group in predicting VETC-positive HCC was 0.790[95%confidence interval(CI)0.720-0.859].The AUC of the validation group in predicting VETC-positive HCC was 0.779(95%CI 0.668-0.889).The calibration curve diagram showed that the calibration curve(the slope was 0.91)almost coincides with the ideal curve,indicating that the prediction model had better calibration.Conclusion The qualitative and quantitative characteristics of Gd-EOB-DTPA enhanced MRI can be used to predict VETC-positive HCC preoperatively,the independent risk factors of VETC include portal phase peripheral washout,necrosis or severe ischemia,targetoid transitional phase or hepatobiliary phase,and LLR on arterial phase.