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https://soar-ir.repo.nii.ac.jp/oai
oai:soar-ir.repo.nii.ac.jp:00019347
2022-12-14T04:15:16Z
882:883
Gd-EOB-DTPA造影MRIによる定量的肝機能評価
Quantitative Evaluation of Liver Function with Use of Gd-EOBDTPA-Enhanced Magnetic Resonance Imaging
Quantitative Evaluation of Liver Function with Use of Gd-EOBDTPA-
Enhanced Magnetic Resonance Imaging
山田, 哲
The quantitative evaluation of liver function is important not only for its monitoring but also for the preoperative evaluation of liver reserve. Indocyanin green (ICG) clearance has been used for reliable quantitative liver function test; however, ICG clearance cannot evaluate segmental liver function. Gd-EOB-DTPA is a bolus-injectable paramagnetic contrast medium taken into hepatocytes via organic anion-transporting polypeptide (OATP) specifically expressed on the cell membrane of hepatocytes; therefore, quantitative evaluation of segmental liver function using Gd-EOB-DTPAenhanced MR imaging could be feasible. The methods for quantitative evaluation of liver function using Gd-EOB-DTPA-enhanced MR imaging can be divided into two major categories: dynamic and static methods. In dynamic methods, time-intensity curve obtained from dynamic contrast-enhanced MR imaging is analyzed using various pharmacokinetic models. Compartment model analysis and deconvolution analysis are representative methods categorized as dynamic model-dependent analysis and dynamic model-independent analysis, respectively. Various parameters can be obtained by these dynamic methods; however, data acquisition and data analysis are complicated compared with those in static methods. In static methods, post-contrast-enhanced images, usually at the hepatobiliary phase, are analyzed using relaxation time or signal intensity of the liver. These static methods are easy to apply in clinical practice. The hepatocellular uptake index (HUI) is a static signal intensity-based method, which is derived from the signal intensities and volumes of the liver and spleen on Gd-EOB-DTPA-enhanced MR images at the hepatobiliary phase. HUI is the only currently available method that can evaluate segmental liver function quantitatively with proven correlation with reliable quantitative liver function tests such as ICG clearance. HUI is useful in the preoperative evaluation of liver reserve prior to transcatheter arterial chemoembolization (TACE) or hepatectomy. In this article, the pharmacokinetics of Gd-EOB-DTPA is first described using the compartment model. Then, derivations of the dual-inlet two-compartment uptake model and HUI are shown as examples of quantitative evaluation of liver function using Gd-EOB-DTPA-enhanced MR imaging. Finally, clinical application of HUI in TACE and hepatectomy is introduced.
Article
日独医報. 58(2):49-56 (2013)
バイエル薬品
2013
jpn
journal article
VoR
http://hdl.handle.net/10091/00020108
https://soar-ir.repo.nii.ac.jp/records/19347
0912-0351
AN00184192
日独医報
58
2
49
56
https://soar-ir.repo.nii.ac.jp/record/19347/files/NICHIDOKU-IHO_58_02_08.pdf
application/pdf
940.0 kB
2017-12-25