A functional liver imaging score for preoperative prediction of liver failure after hepatocellular carcinoma resection

被引:17
作者
Luo, Ningbin [1 ]
Huang, Xiangyang [1 ]
Ji, Yinan [2 ]
Jin, Guanqiao [1 ]
Qin, Yunying [1 ]
Xiang, Bangde [2 ]
Su, Danke [1 ]
Tang, Weizhong [2 ]
机构
[1] Guangxi Med Univ, Dept Radiol, Canc Hosp, Nanning, Peoples R China
[2] Guangxi Med Univ, Dept Surg, Canc Hosp, Nanning, Peoples R China
关键词
Hepatocellular carcinoma; Hepatectomy; Liver failure; Magnetic resonance imaging; Gd-EOB-DTPA; CHILD-PUGH SCORE; MELD SCORE; MORTALITY; DISEASE; MODEL; HEPATECTOMY;
D O I
10.1007/s00330-022-08656-z
中图分类号
R8 [特种医学]; R445 [影像诊断学];
学科分类号
1002 ; 100207 ; 1009 ;
摘要
Objectives Posthepatectomy liver failure (PHLF) is a challenging complication after resection to treat hepatocellular carcinoma (HCC), and it is associated with high mortality. Preoperative prediction of PHLF may improve patient subsequent and reduce such mortality. This study examined whether a functional liver imaging score (FLIS) based on preoperative gadoxetic acid-enhanced magnetic resonance imaging (MRI) could predict PHLF. Materials and methods The study included 502 patients who underwent preoperative gadoxetic acid-enhanced MRI, followed by HCC resection. Significant preoperative predictors of PHLF were identified using logistic regression analysis. The ability of FLIS to predict PHLF was evaluated using receiver operating characteristic curves, and its predictive power was compared to that of the model for end-stage liver disease (MELD) score, albumin-bilirubin (ALBI) score, and indocyanine green 15-min retention rate (ICG-R15). Results In multivariate analysis, PHLF was independently associated with FLIS (OR 0.452, 95% CI 0.361 to 0.568, p < 0.001) and major resection (OR 1.898, 95% CI 1.057 to 3.408, p = 0.032). FLIS was associated with a higher area under the receiver operating characteristic curve (0.752) than the MELD score (0.557), ALBI score (0.609), or ICG-R15 (0.605) (all p < 0.05). Patients with FLIS <= 4 who underwent major resection were at 9.4-fold higher risk of PHLF than patients with lower FLIS who underwent minor resection. Conclusion FLIS is an independent predictor of PHLF, and it may perform better than the MELD score, ALBI score, and ICG-R15 clearance. We propose treating elevated FLIS and major resection as risk factors for PHLF.
引用
收藏
页码:5623 / 5632
页数:10
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