目的探讨钆塞酸二钠(Gd-EOBDTPA)增强MRI对肝硬化病理分级的评估 价值。方法 选取60例因非原发性肝癌而 行手术治疗的患者为研究对象，根据术 后病理结果，将患者分为纤维化组、肝 硬化组及正常组，比较不同程度肝脏病 变患者的MRI信号变化。结果 (1)相关 性分析发现，肝脏病理状态与AEV(r=- 0.527，P＜0.001)、CER(r=-0.742，P ＜0.001)呈显著的负相关关系。即病变 程度越重，MRI信号增强强度及对比增强 率越低。(2)相关性分析发现，肝硬化病 理分级与AEV(r=-0.531，P＜0.001)、 CER(r=-0.725，P＜0.001)呈显著的负相 关关系。肝硬化病理分级越高，AEV越 弱，CER越低。(3)ROC曲线显示，CER对肝 纤维化、肝硬化诊断的AUC为0.693，特 异度为63.7%、灵敏度为86.5%，95%CI为 0.460～0.899；对轻度、中度肝硬化诊断 的AUC为0.863；对中度、重度肝硬化诊 断的AUC为0.836。结论 Gd-EOB-DTPA增 强MRI对肝硬化病理分级有很高的诊断价 值，有一定临床应用价值。

Objective To evaluate the value of Gd-EOB-DTPA enhanced MRI in the pathological grading of liver cirrhosis. Methods 60 patients were divided into fibrosis group, cirrhosis group and normal group. The changes of MRI signal in patients with different degrees of liver diseases were compared. Results (1)Correlation analysis showed that the pathological status of liver was negatively correlated with AEV and CER. The more severe the lesion, the lower the MRI signal intensity and contrast enhancement rate. (2)Correlation analysis showed that there was a significant negative correlation between pathological grading of liver cirrhosis and AEV and CER. The higher the pathological grade of liver cirrhosis, the weaker the AEV and the lower the CER. (3)ROC curve showed that AUC of CER was 0.693 for liver fibrosis and cirrhosis, 0.863 for mild and moderate cirrhosis, and 0.836 for moderate and severe cirrhosis. Conclusion GdEOB-DTPA enhanced MRI has a high diagnostic value for pathological grading of liver cirrhosis, and has a certain clinical value.