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中国癌症防治杂志

中国癌症防治杂志 ›› 2026, Vol. 18 ›› Issue (1): 43-50.doi: 10.3969/j.issn.1674-5671.2026.01.06

• 论著 • 上一篇    下一篇

BMI水平对肝脏病变患者动脉期呼吸运动伪影的影响:基于钆塞酸二钠增强MRI

  

  1. 广西医科大学附属肿瘤医院医学影像中心
  • 出版日期:2026-02-25 发布日期:2026-03-26
  • 通讯作者: 卢飞臣 E-mail:lufeichen9794@163.com
  • 基金资助:
    国家自然科学基金项目（82560356）；广西重点研发计划项目（桂科AB24010038）；北京医学奖励基金会项目（睿影科研基金第六期项目）（YXJL?2024?0350?0314）

 Effect of BMI levels on arterial phase respiratory motion artifacts in patients with liver disease: based on gadoxetic acid disodium enhanced MRI

  • Online:2026-02-25 Published:2026-03-26

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摘要： 目的 探讨肝脏病变患者身体质量指数（body mass index，BMI）与行钆塞酸二钠增强MRI动脉期呼吸运动伪影（transient severe motion，TSM）的相关性及其剂量⁃反应关系，为准确识别和预防动脉期TSM的发生提供参考。方法 采用前瞻性研究设计，纳入2024年3月至2025年11月于广西医科大学附属肿瘤医院行钆塞酸二钠增强MRI检查的肝脏病变患者。使用多因素Logistic回归分析BMI与动脉期TSM的关系，并进行亚组分析观察不同人群中两者的相关性。使用限制性立方样条（resticted cubic splines，RCS）揭示两者的潜在非线性关联。结果  共纳入792例患者，分为3组：偏瘦/体重正常组(n=484)、超重组(n=158)、肥胖组(n=150)，其中动脉期发生TSM 270例（34.1%）。在调整相关混杂因素后，与偏瘦/体重正常组相比，肥胖组发生动脉期TSM风险显著升高（OR=2.88，95%CI：1.82~4.55，P<0.001），且BMI每增加1个标准差（4.51 kg/m²），动脉期TSM发生风险增加49.0%（OR=1.49，95%CI：1.26~1.77，P<0.001）。RCS分析显示，BMI与动脉期TSM之间呈线性正相关（总体关联性检验P<0.001；非线性检验P=0.927）。亚组分析结果显示，既往有接受钆塞酸二钠增强MRI检查史对BMI与动脉期TSM的关联性存在显著的交互作用（交互作用P=0.016）。结论 肥胖是肝病变患者行钆塞酸二钠增强MRI动脉期TSM发生的独立危险因素，随着BMI增加，动脉期TSM发生风险逐渐升高。临床上应关注高BMI患者，尤其是首次受检者，应采取针对性准备与采集策略以提高动脉期图像质量。

关键词: 肝脏肿瘤, 钆塞酸二钠, 增强MRI, 呼吸运动伪影, 身体质量指数, 肥胖

Abstract: Objective Gadoxetic acid disodium (Gd‑EOB‑DTPA) enhanced magnetic resonance imaging (MRI) plays a crucial role in the detection and characterization of hepatic lesions, However, arterial phase images are frequently degraded by transient severe motion (TSM) artifacts, which may be associated with body mass index (BMI). This study aims to investigate the relationship and dose⁃response association between BMI and TSM in Gd⁃EOB⁃DTPA enhanced MRI, and to provide the evidence for the accurate identification and prevention of arterial⁃phase TSM. Methods This prospective study enrolled patients with liver lesions who underwent Gd⁃EOB⁃DTPA enhanced MRI at Guangxi Medical University Cancer Hospital from March 2024 to November 2025. Multivariable Logistic regression was used to evaluate the association between BMI and arterial⁃phase TSM. Four stepwise adjusted models were established. Model 1 was unadjusted, Model 2 adjusted for demographic factors, Model 3 additionally included lifestyle factors, and Model 4 was comprehensively adjusted for clinical covariates. Subgroup analysis was performed to observe the correlation between BMI and arterial TSM across different populations. Restricted cubic splines (RCS) were applied to explore potential non⁃linear relationships. Results A total of 792 patients were included in the study and categorized into three groups: the underweight/normal⁃weight group (n=484), the overweight group (n=158), and the obese group (n=150). Arterial⁃phase TSM occurred in 270 patients (34.1%). After adjustment for relevant confounders, compared with the underweight/normal⁃weight group, the obese group had a significantly higher risk of arterial⁃phase TSM (OR=2.88, 95%CI: 1.82-4.55; P<0.001). A 1⁃standard⁃deviation increase in BMI (4.51 kg/m²) was associated with a 49% higher risk of arterial⁃phase TSM (OR=1.49, 95%CI: 1.26-1.77; P<0.001). RCS analysis showed a linear positive association between BMI and arterial⁃phase TSM within a BMI range of 15-40 kg/m² (P for overall association<0.001; P for nonlinearity=0.927). Subgroup analyses indicated a significant interaction between prior Gd⁃EOB⁃DTPA enhanced MRI history and the BMI⁃TSM association (P for interaction=0.016). Conclusions Obesity is an independent risk factor for arterial⁃phase TSM on Gd⁃EOB⁃DTPA enhanced MRI, and the risk of arterial⁃phase TSM increasing with BMI. Clinical practice should pay particular attention to patients with elevated BMI, especially those undergoing first⁃time examinations, by implementing implement targeted preparation and acquisition strategies to improve arterial⁃phase image quality.

Key words: Liver cancer, Gadoxetic acid disodium, Enhanced MRI, Respiratory motion artifact, Body mass index, Obesity

中图分类号: 

  • R735.7