Value of contrast agent uptake related parameters of gadolinium ethoxybenzyl diethylenetriamine pentaacetic acid enhanced magnetic resonance imaging in evaluating the severity of drug induced liver injury in hepatobiliary phase

doi:10.3877/cma.j.issn.2095-2015.2022.04.003

Abstract

Abstract:

Objective

To investigate the value of parameters obtained from gadolinium ethoxybenzyl diethylenetriamine pentaacetic acid (Gd-EOB-DTPA) uptake in hepatobiliary phase of enhanced magnetic resonance imaging (MRI) for evaluating the severity of drug induced liver injury.

Methods

A total of 55 patients with drug induced liver injury admitted to North Jiangsu People's Hospital from January 2020 to June 2021 were selected, including 29 patients in the mild group and 26 patients in the severe group. Thirty patients with normal liver function were selected as control group. Gd-EOB-DTPA enhanced MRI images of patients were retrospectively analyzed. The signal intensity of liver, portal vein and spleen before enhancement and in hepatobiliary phase were measured, and the liver relative enhancement (RE), the enhancement degree of liver relative to portal vein (LPC), and the ratio of liver to spleen (LSC) were calculated. Functional liver imaging score (FLIS) was also performed. The parameters of the control group, mild drug-induced liver injury group and severe drug-induced liver injury group were compared. Pearson correlation analysis was used to analyze the correlation between hepatobiliary phase parameters and liver injury biochemical indexes in enhanced MRI. Receiver operating characteristic (ROC) curves were drawn to analyze the efficacy of different parameters in differentiating the mild and severe liver injury group.

Results

The parameters of RE, LPC and LSC in patients with drug induced liver injury were lower than those in the control group, and the parameters decreased gradually with the aggravation of liver injury, with statistically significant differences (all P<0.05). RE and LPC were moderately negatively correlated with the level of total bilirubin (r=-0.53, -0.51, P<0.05) and moderately positively correlated with the level of total protein (r=0.54, 0.53, P<0.05) in patients with drug induced liver injury. The areas under the ROC curve of RE, LPC, LSC, LFIS for distinguishing the mild and severe drug induced liver injury groups were 0.74, 0.81, 0.74, 0.78 respectively.

Conclusion

The parameters related to Gd-EOB-DTPA enhanced MRI in hepatobiliary phase can evaluate the severity of drug induced liver injury, providing a new auxiliary method for clinical quantitative assessment of drug induced liver injury severity.

Key words: Gadolinium ethoxybenzyl diethylenetriamine pentaacetic acid, Magnetic resonance imaging, Drug induced liver injury

Xiaoxiao Wang, Jinghui Hu, Jinyun Liu, Junfei Chen, Jingcheng Huang, Xianfu Luo. Value of contrast agent uptake related parameters of gadolinium ethoxybenzyl diethylenetriamine pentaacetic acid enhanced magnetic resonance imaging in evaluating the severity of drug induced liver injury in hepatobiliary phase[J]. Chinese Journal of Digestion and Medical Imageology(Electronic Edition), 2022, 12(04): 204-209.

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URL: https://zhxhbyyxzz.cma-cmc.com.cn/EN/10.3877/cma.j.issn.2095-2015.2022.04.003

https://zhxhbyyxzz.cma-cmc.com.cn/EN/Y2022/V12/I04/204

Figures/Tables 9

References 18

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组别	例数	年龄（±s，岁）	性别（男性/女性，例）
DILI组	55	61.5±8.5	21/34
非DILI组	30	46.5±10.5	11/19
统计值		t=-1.21	χ²=0.19
P值		0.22	0.89

组别	例数	年龄（±s，岁）	性别（男性/女性，例）
DILI组	55	61.5±8.5	21/34
非DILI组	30	46.5±10.5	11/19
统计值		t=-1.21	χ²=0.19
P值		0.22	0.89

指标		轻症DILI组（n=29）	重症DILI组（n=26）	统计值	P值
年龄（±s，岁）		57.4±10.8	61.1±12.7	t=1.27	0.26
性别（男性/女性，例）		14/15	7/19	-	0.70^a
胆囊壁增厚、水肿[例（%）]		14（48.3）	18（69.2）	χ²=2.47	0.11
腹水[例（%）]		9（31.0）	9（34.6）	χ²=0.08	0.07
脾大[例（%）]		3（10.3）	4（15.4）	-	0.87^a
临床分型[例（%）]				-	0.26^a
	肝细胞型	14（48.3）	18（69.2）
	胆汁淤积型	13（44.8）	6（23.1）
	混合型	2（6.9）	2（7.7）

指标		轻症DILI组（n=29）	重症DILI组（n=26）	统计值	P值
年龄（±s，岁）		57.4±10.8	61.1±12.7	t=1.27	0.26
性别（男性/女性，例）		14/15	7/19	-	0.70^a
胆囊壁增厚、水肿[例（%）]		14（48.3）	18（69.2）	χ²=2.47	0.11
腹水[例（%）]		9（31.0）	9（34.6）	χ²=0.08	0.07
脾大[例（%）]		3（10.3）	4（15.4）	-	0.87^a
临床分型[例（%）]				-	0.26^a
	肝细胞型	14（48.3）	18（69.2）
	胆汁淤积型	13（44.8）	6（23.1）
	混合型	2（6.9）	2（7.7）

组别	例数	RE	LPC	LSC
DILI组	55	0.5±0.4	1.4±0.7	1.0±0.2
非DILI组	30	1.2±0.5	2.4±0.6	1.2±0.1
t值		34.06	29.46	17.06
P值		<0.05	<0.05	<0.05

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