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Received:December 22, 2022 Published Online:September 19, 2023
Received:December 22, 2022 Published Online:September 19, 2023
中文摘要: 目的 探讨钆塞酸二钠(Gd-EOB-DTPA)增强MRI评估食管静脉曲张程度的价值。方法 回顾性分析2021年9月至2022年6月于江苏省中医院临床综合诊断为乙型肝炎肝硬化并行Gd-EOB-DTPA增强MRI检查的患者114例,并以食管静脉宽度3 mm为诊断阀值,分为无静脉曲张组、小静脉曲张组及大静脉曲张组,分别测量各组平扫和肝胆期(增强后20 min)肝脏、脾脏及竖脊肌信号强度(SI),并计算肝脏相对强化度(RLE)、对比吸收指数(CUI)、肝-脾对比指数(LSI)。比较各组间指标差异,并绘制受试者工作特征曲线(ROC),采用曲线下面积(AUC)评估各指标对大静脉曲张的诊断效能。结果 无静脉曲张组RLE、CUI、LSI均与大静脉曲张组存在显著差异(P<0.05),而RLE、CUI、LSI在小静脉曲张组与无静脉曲张组、小静脉曲张组与大静脉曲张组之间差异无统计学意义(P>0.05)。RLE、CUI及LSI诊断大静脉的AUC分别为0.668(95%CI:0.558~0.793)、0.676(95%CI:0.567~0.804)、0.685(95%CI:0.550~0.780)。结论 Gd-EOB-DTPA增强MRI对于评价食管静脉曲张程度具有一定的价值。
Abstract:Objective To explore the value of gadolinium ethoxybenzyl diethylenetriamine pentaacetic acid (Gd-EOB-DTPA) enhanced MRI in evaluating the degree of esophageal varices. Methods Clinical data of 114 patients diagnosed with hepatitis B cirrhosis and Gd-EOB-DTPA enhanced MRI examination through clinical comprehensive diagnosis at Jiangsu Provincical Hospital of Chinese Medicine from September 2021 to June 2022 was retrospective analyzed. The patients were divided into non-varicose vein group, small varicose vein group and large varicose vein group based on the diagnostic threshold of 3 mm esophageal vein width. The signal intensity (SI) of liver, spleen and erector spinae muscles were measured in each group during the plain scan and hepatobiliary phase (20 minutes after enhancement). The relative liver enhancement (RLE), contrast uptake index (CUI), and liver-to-spleen contrast index (LSI) were calculated. The differences in indicators between each group were compared, and the receiver operating characteristic curve (ROC) were drawn. The area under the curve (AUC) was used to evaluate the diagnostic efficacy of each indicator in diagnosing varicose veins. Results There was a significant difference in RLE, CUI, and LSI between the non-varicose vein group and the large varicose vein group (P<0.05), while there was no significant difference in RLE, CUI, and LSI between the small varicose vein group, as well as between small varicose vein group and large varicose vein group (P>0.05). The AUC of RLE, CUI and LSI for diagnosing large varicose veins was 0.668 (95%CI: 0.558-0.793), 0.676 (95%CI: 0.567-0.804) and 0.685 (95%CI: 0.550-0.780), respectively. Conclusion Gd-EOB-DTPA enhanced MRI has certain value in evaluating the degree of esophageal varices.
keywords: Magnetic resonance imaging Gadolinium ethoxybenzyl diethylenetriamine pentaacetic acid Esophageal varices Hepatitis B cirrhosis
文章编号: 中图分类号:R445.2 文献标志码:B
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