PDF(Pubmed)
Abstract：
BACKGROUND: Liver-to-spleen signal intensity ratio (LSR) is evaluated by magnetic resonance imaging (MRI) in the hepatobiliary phase and has been reported as a useful radiological assessment of regional liver function. However, LSR is a passive (non-time-associated) assessment of liver function, not a dynamic (time-associated) assessment. Moreover, LSR shows limitations such as a dose bias of contrast medium and a timing bias of imaging. Previous studies have reported the advantages of time-associated liver functional assessment as a precise assessment of liver function. For instance, the indocyanine green (ICG) disappearance rate, which is calculated from serum ICG concentrations at multiple time points, reflects a precise preoperative liver function for predicting post-hepatectomy liver failure without the dose bias of ICG or the timing bias of blood sampling. The aim of this study was to develop a novel time-associated radiological liver functional assessment and verify its correlation with traditional liver functional parameters.
METHODS: A total of 279 pancreatic cancer patients were evaluated to clarify fundamental time-associated changes to LSR in normal liver. We defined the time-associated radiological assessment of liver function, calculated using information on LSR from four time points, as the \"LSR increasing rate\" (LSRi). We then investigated correlations between LSRi and previous liver functional parameters. Furthermore, we evaluated how timing bias and protocol bias affect LSRi.
RESULTS: Significant correlations were observed between LSRi and previous liver functional parameters such as total bilirubin, Child-Pugh grade, and albumin-bilirubin grade (P < 0.001 each). Moreover, considerably high correlations were observed between LSRi calculated using four time points and that calculated using three time points (r > 0.973 each), indicating that the timing bias of imaging was minimal.
CONCLUSIONS: This study propose a novel time-associated radiological assessment, and revealed that the LSRi correlated significantly with traditional liver functional parameters. Changes in LSR over time may provide a superior preoperative assessment of regional liver function that is better for predicting post-hepatectomy liver failure than LSR using the hepatobiliary phase alone.
METHODS: A total of 279 pancreatic cancer patients were evaluated to clarify fundamental time-associated changes to LSR in normal liver. We defined the time-associated radiological assessment of liver function, calculated using information on LSR from four time points, as the \"LSR increasing rate\" (LSRi). We then investigated correlations between LSRi and previous liver functional parameters. Furthermore, we evaluated how timing bias and protocol bias affect LSRi.
RESULTS: Significant correlations were observed between LSRi and previous liver functional parameters such as total bilirubin, Child-Pugh grade, and albumin-bilirubin grade (P < 0.001 each). Moreover, considerably high correlations were observed between LSRi calculated using four time points and that calculated using three time points (r > 0.973 each), indicating that the timing bias of imaging was minimal.
CONCLUSIONS: This study propose a novel time-associated radiological assessment, and revealed that the LSRi correlated significantly with traditional liver functional parameters. Changes in LSR over time may provide a superior preoperative assessment of regional liver function that is better for predicting post-hepatectomy liver failure than LSR using the hepatobiliary phase alone.
摘要：
背景：肝脾信号强度比（LSR）通过磁共振成像（MRI）在肝胆阶段进行评估，并已被报道为对区域肝功能的有用放射学评估。然而,LSR是肝功能的被动（非时间相关）评估，不是动态(与时间相关的)评估。此外，LSR示出了诸如造影剂的剂量偏差和成像的定时偏差的限制。先前的研究报道了时间相关的肝功能评估作为肝功能的精确评估的优势。例如,吲哚菁绿（ICG）消失率，从多个时间点的血清ICG浓度计算得出，反映了精确的术前肝功能，可预测肝切除术后肝功能衰竭，而没有ICG的剂量偏差或采血的时间偏差。这项研究的目的是开发一种新颖的时间相关的放射性肝功能评估，并验证其与传统肝功能参数的相关性。
方法：对总共279名胰腺癌患者进行了评估，以阐明正常肝脏中LSR的基本时间相关变化。我们定义了肝功能的时间相关放射学评估，使用四个时间点的LSR信息计算，作为“LSR增长率”(LSRi)。然后，我们研究了LSRi与先前肝功能参数之间的相关性。此外，我们评估了时间偏差和方案偏差如何影响LSRi.
结果：在LSRi和以前的肝功能参数如总胆红素之间观察到显著的相关性，Child-Pugh年级,和白蛋白-胆红素等级（各P<0.001）。此外，在使用四个时间点计算的LSRi和使用三个时间点计算的LSRi之间观察到相当高的相关性(每个r>0.973)，表明成像的时间偏差很小.
结论：这项研究提出了一种新的与时间相关的放射学评估，并显示LSRi与传统肝功能参数显着相关。随着时间的推移，LSR的变化可以提供更好的术前评估区域肝功能，预测肝切除术后肝功能衰竭比LSR单独使用肝胆阶段。
方法：对总共279名胰腺癌患者进行了评估，以阐明正常肝脏中LSR的基本时间相关变化。我们定义了肝功能的时间相关放射学评估，使用四个时间点的LSR信息计算，作为“LSR增长率”(LSRi)。然后，我们研究了LSRi与先前肝功能参数之间的相关性。此外，我们评估了时间偏差和方案偏差如何影响LSRi.
结果：在LSRi和以前的肝功能参数如总胆红素之间观察到显著的相关性，Child-Pugh年级,和白蛋白-胆红素等级（各P<0.001）。此外，在使用四个时间点计算的LSRi和使用三个时间点计算的LSRi之间观察到相当高的相关性(每个r>0.973)，表明成像的时间偏差很小.
结论：这项研究提出了一种新的与时间相关的放射学评估，并显示LSRi与传统肝功能参数显着相关。随着时间的推移，LSR的变化可以提供更好的术前评估区域肝功能，预测肝切除术后肝功能衰竭比LSR单独使用肝胆阶段。
