Journal of the Korean Society of Radiology (대한영상의학회지)

The Korean Society of Radiology (대한영상의학회)
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Quantitative Evaluation of the Hepatic Parenchymal Change in Patients with Chronic Liver Disease Using Gd-EOB-DTPA-enhanced MRI: Comparison with Normal Liver

Gd-EOB-DTPA MRI를 이용한 만성간질환의 간실질에 대한 정량적 평가: 정상간과 비교

  • Lee, Woo-Jin (Department of Diagnostic Radiology, Korea University Ansan Hospital) ;
  • Cha, Sang-Hoon (Department of Diagnostic Radiology, Korea University Ansan Hospital) ;
  • Kim, Min-Yeong (Department of Diagnostic Radiology, Korea University Ansan Hospital) ;
  • Chung, Hwan-Hoon (Department of Diagnostic Radiology, Korea University Ansan Hospital) ;
  • Lee, Seung-Wha (Department of Diagnostic Radiology, Korea University Ansan Hospital) ;
  • Yi, Ann (Department of Diagnostic Radiology, Korea University Ansan Hospital) ;
  • Je, Bo-Kyung (Department of Diagnostic Radiology, Korea University Ansan Hospital) ;
  • Kim, Baek-Hyun (Department of Diagnostic Radiology, Korea University Ansan Hospital)
  • 이우진 (고려대학교 의과대학 고려대학교병원 영상의학과) ;
  • 차상훈 (고려대학교 의과대학 고려대학교병원 영상의학과) ;
  • 김민영 (고려대학교 의과대학 고려대학교병원 영상의학과) ;
  • 정환훈 (고려대학교 의과대학 고려대학교병원 영상의학과) ;
  • 이승화 (고려대학교 의과대학 고려대학교병원 영상의학과) ;
  • 이안 (고려대학교 의과대학 고려대학교병원 영상의학과) ;
  • 제보경 (고려대학교 의과대학 고려대학교병원 영상의학과) ;
  • 김백현 (고려대학교 의과대학 고려대학교병원 영상의학과)
  • Published : 2011.01.01
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Abstract

Purpose: We wanted to evaluate the capability of Gd-EOB-DTPA-enhanced MRI for diagnosing chronic liver disease by comparing the signal intensity change (SIC) of the hepatic parenchyma of patients with chronic liver disease with that of patients with a normal liver. Materials and Methods: This retrospective study included 50 patients who were pathologically confirmed as having liver cirrhosis (n=41) or chronic hepatitis (n=9) by surgery (n=9) or biopsy (n=41), and they all underwent Gd-EOB-DTPA-enhanced MRI between June 2008 and May 2010 (i.e., the patient group). We also analyzed 30 patients with normal livers as the control group. Quantitative image analysis was performed by measuring the signal-to-noise ratios for the pre-contrast images and the post-contrast 2-, 3-, 10-, 20-min delay images and then calculating the SIC of the precontrast and post-contrast images. We performed a detailed analysis of the collected data, which was transformed into a logarithmic form. The SICs of the two groups were compared by Greenhouse-Geisser sphericity correction. Results: Comparison of the SIC between the two groups showed a significant difference on the hepatocyte-phase 20-min image (p<0.0001). The mean SICs with log transformation for the patient and normal groups were 1.90 ${\pm}$ 0.10 and 2.23 ${\pm}$ 0.13, respectively, and the optimal cut-off value of the SIC with log transformation on the 20-min delay hepatocyte-phase image was 2.17 (sensitivity: 66.7%, specificity: 84.0%, positive predictive value: 71.4%, negative predictive value: 80.8%). Conclusion: Quantitative measurement of the SIC on the hepatocyte-phase image by Gd-EOB-DTPA-enhanced MRI could provide a convenient method to noninvasively diagnose chronic liver disease.

목적: Gd-EOB-DTPA MRI에서 만성간질환 환자군과 정상군의 간실질의 조영증강률을 비교하여 만성간질환을 진단할 수 있는지를 평가하고자 한다. 대상과 방법: Gd-EOB-DTPA MRI를 시행한 환자 중 수술(n=9) 또는 조직 생검(n=41)을 통해 간경변증 (n=41) 또는 만성 간염(n=9)으로 병리학적 진단을 받은 50명의 환자를 대상으로 하였다(환자군). Gd-EOBDTPA MRI를 시행한 정상 간을 가진 30명을 대조군으로 하여 비교하였다. 조영증강 전 영상과 2분, 3분, 10분, 20분 지연 조영증강 후 영상에서 간실질의 신호대잡음비를 측정하였으며 조영증강 전 영상과 비교하여 각각의 조영 증강 후 영상에서의 조영증강률을 구하였다. 모든 측정값은 로그 변환 후 분석하였으며 각 군의 조영증강률의 비교는 Greenhouse-Geisser sphericity correction을 이용하였다. 결과: 두 군간의 조영증강률은 20분 간세포시기영상에서 가장 유의한 차이를 나타내었다(p < 0.0001). 평균조영증강률은 환자군과 정상군에서 각각 1.90 ${\pm}$ 0.10과 2.23 ${\pm}$ 0.13으로 측정되었으며, 20분 지연 간세포시기영상에서의 최적 판별 수치는 2.17로 측정되었다(민감도, 특이도, 양성예측도, 음성예측도는 각각 66.7%, 84.0%, 71.4%, 80.8%). 결론: Gd-EOB-DTPA MRI의 간세포시기영상에서 조영증강률의 측정은 만성간질환을 진단하는데 편리하고 비침습적인 방법으로 유용하게 이용될 수 있다.

Keywords

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