Application value of preoperative assessment of liver reserve function based on magnetic resonance cholangiopancreatography-related parameters and liver-to-muscle ratio in patients with hepatic space-occupying lesion
- VernacularTitle:磁共振成像胆道评分和肝肌比值对肝占位患者术前肝储备功能的评估价值
- Author:
Yanhong YE
1
;
Lijian LU
1
Author Information
- Publication Type:Journal Article
- Keywords: Liver Neoplasms; Magnetic Resonance Imaging; Nomograms
- From: Journal of Clinical Hepatology 2025;41(9):1845-1852
- CountryChina
- Language:Chinese
- Abstract: ObjectiveTo establish a nomogram predictive model based on magnetic resonance cholangiopancreatography-related parameters and liver-to-muscle ratio， and to investigate the application value of this model in preoperative assessment of liver reserve function in patients with hepatic space-occupying lesion. MethodsClinical data and Gd-EOB-DTPA MRI imaging data were collected from 112 patients with hepatic space-occupying lesion who were hospitalized and scheduled for surgery in Wuming Hospital of Guangxi Medical University from April 2022 to April 2024. According to the degree of liver injury， the patients were divided into Child-Pugh class A group （65 patients with compensated liver function） and Child-Pugh class B+C group （47 patients with decompensated liver function， including 42 patients with Child-Pugh class B liver function and 5 patients with Child-Pugh class C liver function）. The two groups of patients were measured in terms of liver-to-muscle ratio， relative signal intensity of the common bile duct， and bile duct score in different phases of contrast-enhanced CT scan， and univariate and multivariate Logistic regression analyses were used to identify independent predictive factors and establish a nomogram model. In addition， the receiver operating characteristic （ROC） curve， the calibration curve， and the decision curve were plotted to assess the discriminatory ability， accuracy， and clinical application value of the model. The independent-samples t test was used for comparison of normally distributed continuous data between two groups， and the Mann-Whitney U test was used for comparison of data with skewed distribution between two groups； the chi-square test was used for comparison of categorical data between two groups. ResultsThere were significant differences between the two groups in liver-to-muscle ratio at 5 minutes （Z=-3.99， P0.001）， 10 minutes （Z=-4.39， P0.001）， 15 minutes （Z=-4.23， P0.001）， and 20 minutes （Z=-5.40， P0.001） during the hepatobiliary phase， the relative enhancement degree of the common bile duct （Z=-4.85， P0.001）， and bile duct score （t=7.99， P0.001）. The multivariate Logistic regression analysis showed that liver-to-muscle ratio at 10 minutes during the hepatobiliary phase （odds ratio ［OR］=0.63， 95% confidence interval ［CI］： 0.44 — 0.90， P0.05）， liver-to-muscle ratio at 20 minutes during the hepatobiliary phase （OR=0.38， 95%CI： 0.17 — 0.82， P0.05）， and bile duct score （OR=0.17， 95%CI： 0.07 — 0.39， P0.05） were independent influencing factors for the preoperative diagnosis of liver function decompensation. The nomogram model established based on liver-to-muscle ratio at 10 minutes during the hepatobiliary phase， liver-to-muscle ratio at 20 minutes during the hepatobiliary phase， and bile duct score had an area under the ROC curve of 0.905 （95%CI： 0.849 — 0.960）， with a sensitivity of 78.7% with a specificity of 89.2%. ConclusionThe nomogram model established based on the liver-to-muscle ratio at 10 and 20 minutes during the hepatobiliary phase and bile duct score can effectively assess the status of liver reserve function in patients with hepatic space-occupying lesion before surgery.
