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Objective To probe the value of both liver volume(LV)measurement and Gd-EOB-DTPA enhanced MRI to evaluate hepatic reserve function in order to obtain a better assessment method.Methods Clinical and imaging data of 42 patients with hepatic focal lesions were analyzed retrospectively.Gd-EOB-DTPA enhanced MRI scan,Child-Pugh scoring and ICG clearance tests were performed in all patients,and the liver relative enhancement (RE)and LV were used to assess the hepatic reserve function.The differences of LV, LV/standard liver volume (SLV)and RE between the Child-Pugh class A and B were compared using independent student's t-test. Spearman correlation analysis was applied to analyze the relationship of indocyanine green retention rate at 1 5 minutes (ICG-R1 5) with the LV,LV/SLV,RE,RE×LV and RE×LV/SLV.Results There was no significant difference in LV between two groups(P>0.05), whereas the RE had significant difference(P=0.039).There were no significant correlations between ICG-R15 and LV,LV/SLV(P>0.05). ICG-R1 5 was negatively correlated with RE,RE×LV and RE×LV/SLV,and RE×LV/SLV showed significant correlation with ICG-R15 (r=-0.524,P=0.000).Conclusion Gd-EOB-DTPA enhanced MRI can assess the status of hepatic reserve function, while the combination of RE with LV is a more effective method.
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Posthepatectomy liver failure (PHLF) is a major cause of perioperative death after hepatectomy. This article summarizes the current status of research on risk factors contributing to PHLF, prediction methods, preventive measures, and related expert consensus, and it is pointed out that an objective evaluation of liver function before surgery, a reasonable design of the method of liver resection, and accurate operation are the key measures to reduce the incidence rate of PHLF.
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Objective To evaluate the clinical usefulness of determining the liver reserve function by estimating the retention rate of indocyanine green at fifteen minutes(ICGR15) before interventional chemoembolization in treating patients with primary hepatocellular carcinoma(HCC).Methods Forty-three patients with HCC were enrolled in this study.Before interventional chemoembolization ICGR15 and Child-Pugh classification were estimated in all patients.Based on the ICGR15,the patients were divided into three groups.After chemoembolization,all the patients were divided into two groups according to liver function condition: group M(showing mild hepatic dysfunction) and group S(developing severe hepatic dysfunction).The occurrence of postoperative hepatic dysfunction and the difference in the hepatic function changes between three groups were analyzed.Results After interventional chemoembolization the occurrence of hepatic dysfunction were significantly different between three groups divided by ICGR15 test(P