Objective With ALBI grade as the reference of liver function assessment,to evaluate the efficacy of func-tional liver imaging score(FLIS)and its three imaging signs in predicting liver function by analyzing the hepatobiliary phase(HBP)images of patients with chronic liver disease.Methods The clinical and imaging data of 170 patients with chronic liver disease who underwent Gd-EOB-DTPA enhanced MRI from February 2022 to April 2023 were retrospectively analyzed.ALBI score was calculated according to laboratory indicators and patients were divided into three groups:ALBI grade 1,2 and 3.FLIS and the scores of three imaging signs(liver parenchymal enhancement,biliary contrastexcretion,por-tal vein sign)were evaluatedusing HBP images independently by two radiologists.The correlations between ALBI score and both FLIS and its three parameters were assessed by Spearman's rank correlation and Kruskal-Wallis H test was used to an-alyze the differences of these imaging parameters among different ALBI grades.Receiver operating characteristic(ROC)curve analysis was performed to evaluate the diagnostic efficacy of FLIS and imaging signs in distinguishing different ALBI grades.Inter-reader agreements were evaluated by intraclass correlation coefficient(ICC).Results FLIS and three ima-ging signs all showed strong correlations with ALBI grades.The correlation coefficient of FLIS was the highest(r =-0.735,P<0.001).Kruskal-Wallis H test showed that there was no significant difference in biliary contrast excretion score be-tween ALBI grade 1 and grade 2(P =0.111>0.05),but other imaging parameters showed significant differences among different ALBI grades(P =0.000).ROC curve analysis showed that FLIS had the highest diagnostic efficacy in distinguis-hing different ALBI grades compared with the other three imaging signs,with AUC values of 0.846(ALBI1 vs.ALBI2 or 3)and 0.952(ALBI 3 vs.ALBI 1 or 2),respectively.The inter-reader agreements for FLIS,liver parenchymal enhance-ment,biliary contrast excretion and portal vein sign were excellent,with ICC values of 0.951,0.847,0.930 and 0.945,re-spectively.Conclusion Compared with other three parameters,FLIS showed the strongest correlation with ALBI score and can accurately stratify the ALBI grades.FLIS is expected to be a simple and non-invasive imaging indicator to evaluate liver function in patients with chronic liver disease and has the potential to guide patients'clinical managements.
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