Measurement of Hepatic Functional Reserve by Functional Liver Imaging: Correlation with Clinical and Laboratory Findings

초록

Purpose: To evaluate the feasibility of functional liver imaging (FLI) as a new method for measuring hepatic functional reserve (HFR). Materials and Methods: Twenty-two patients with cirrhotic liver with various functional impairments (Child class A, 10; B, 7; C, 5) were included in our series. Our series also included 28 normal volunteers as a control group. All cases (n=50) underwent the FLI. The Mn-DPDP enhanced MR imaging for the liver was performed at 1.5T GE Signa Horizon (GE Medical System, Milwaukee, USA) system using enhanced 3D fast gradient echo (EFGRE-3D) sequence (TR/TE = 4.7/1.1 msec; flip angle, 20.0 degree) and torso-coil. The remaining post-processing of the FLI was performed at a SUN Sparc 20 work station in all cases. We evaluated the correlation between the HFR calculated from FLI data (HFR-FLI) and Child score, Child class, and the retention rate of indocyanine green (ICG) 15 minutes after administration (ICG-R15). Results: The HFR was successfully obtained by calculation using the data of FLI in all cases. The mean ± standard deviations of HFR-FLI in normal and cirrhotic livers with Child class A, B, and C were 113.9 ± 8.2 %, 85.3 ± 7.8 %, 57.9 ± 8.1 %, and 37.3 ± 4.9 %, respectively, and they were significantly different with each other (p < .05). The mean value of HFR-FLI decreased significantly with increasing Child score, Child class, and ICG-R15 (p < .05). The change of HFR-FLI was well correlated with that of the above clinical and laboratory findings (β < -0.846, p < .05). Conclusion The change of HFR-FLI was well correlated with that of Child score, Child class, and ICG-R15 with statistical significance. Therefore, the FLI seems to be a feasible substitute for various conventional methods for measuring HFR.