Gd-EOB-DTPA增强MRI肝细胞期加大偏转角的价值  

Value of Increasing the Flip Angle on Gd-EOB-DTPA Enhanced Hepatocyte Phase MRI

作　　者：李海良[1] 祝跃明[1] 李凤琪 陈良[1] 

机构地区：[1]浙江省湖州市中心医院放射科,313000

出　　处：《医学研究杂志》2013年第4期111-115,共5页Journal of Medical Research

基　　金：浙江省湖州市科技局基金资助项目(2010YS10)

摘　　要：目的确定钆塞酸二钠(Gd-EOB-DTPA)增强MRI肝细胞期,高偏转角扫描(FA)是否比标准低偏转角扫描能提高肝局灶性病变(FLL)的检出率。方法对62例患者159个FLL在Gd-EOB-DTPA增强MRI肝细胞期第5、10、15、20min行10°和30°两组偏转角扫描成像。2位放射医师采用4分信度法独立和随机判读两组图像,测量肝细胞期所有图像的病灶-肝实质对比信噪比(CNR),并计算敏感度和特异性。结果所有时间点上高偏转角扫描成像的病灶-肝实质CNR显著高于低偏转角成像(P<0.001),2位医师在所有时间点检测恶性小FLL(≤10mm)的敏感度,高偏转角成像显著高于低偏转角成像(P<0.05),两组扫描方法检测所有FLL的特异性为同样高(98.2%),无显著差异(P=1.000)。结论 Gd-EOB-DTPA增强MRI肝细胞期加大偏转角能显著增加病灶-肝实质CNR,提高FLL尤其是小恶性病灶的检出率。Objective To determine whether hepatoeyte phase gadoxetic acid disodium enhanced MRI using a high ？ ip angle （FA） improves focal liver lesion （FLL） detection compared with using a standard low FA. Methods Sixty -two consecutive patients with 159 FLLs underwent Gd - EOB - DTPA enhanced MRI during the hepatocyte phase at 5, 10, 15, and 20 min, with both low （ 10°） and high （30°） FAs. Two radiologists independently and randomly reviewed the two image sets using a four- point rating scale. Sensitivities and specificities were calculated and lesion- to -liver contrast noise ratio （CNR） on all hepatocyte phase images was measured. Results CNR with high FA were significantly higher than those with low FA at all time points （P 〈 0. 001 ） ,The sensitivities with high FA for small （ ≤ 10mm）malignant FLLs were significantly higher than those with low FA, at all time points, for both radiologists （P 〈 0. 05 ）. Mean- while, the specificities of the two protocols for the detection of all FLLs at all time points during the hepatocyte phase were high and same （98.2%） ,without any significant differences （P = 1. 000）. Conclusion Hepatocyte phase Gd - EOB - DTPA enhanced MRI with in- creasing FA can significantly increase CNR and improve the detection of FLLs, particularly small malignant lesions.

关 键 词：磁共振成像 钆塞酸二钠 肝局灶性病变 偏转角 

分 类 号：R735.7[医药卫生—肿瘤]