Gd-EOB-DTPA MR增强检查在肝癌TACE术后患者中的应用  

Gd-EOB-DTPA magnetic resonance imaging in hepatocellular carcinoma patients after transcatheter arterial chemoembolization

作　　者：金倩娜[1] 杨君[1] 吴志强[1] 冯仕庭[1] 李子平[1] 杨建勇[1] 

机构地区：[1]中山大学附属第一医院医学影像科,广东广州510080

出　　处：《实用放射学杂志》2014年第5期808-811,821,共5页Journal of Practical Radiology

摘　　要：目的：比较 Gd-EOB-DTPA-MR与CT、DSA检查在肝癌肝动脉化疗栓塞术（TACE）后患者的影像学表现间的相关性,分析这一新型肝细胞特异性 MR对比剂在肝癌TACE术后患者复查中的意义。方法17例患者均为肝癌 TACE术后复查,均行上腹部平扫加动态增强 MR扫描及平扫加增强CT扫描。患者行 MR与CT检查的间隔时间平均为14 d,MR与再次 TACE间隔时间平均为25 d。按照 m-RECIST标准选取共69个病灶,其中直径〉2.0 cm的病灶22个,直径≤2.0 cm 的病灶47个。对选取的病灶的3种影像学检查结果行Friedman秩和检验。对直径≤2.0 cm的病灶的 CT及 MR检查结果行Wilcoxon 秩和检验。结果直径〉2.0 cm的病灶,3种检查方法没有显著性差异。直径≤2.0 cm的病灶,3种检查方法有显著差异性,其 CT及 MR检查结果亦有差异性。结论 Gd-EOB-DTPA 增强MR检查避免了CT易漏诊的碘油沉积灶旁复发灶,对于小复发灶的检测更敏感,应更大范围推广应用于肝癌TACE术后患者的复查随访中。Objective The present study compared 3.0-T Gd-EOB-DTPA magnetic resonance imaging with conventional angiog-raphy and enhanced-CT examination for the identification of hepatocellular carcinoma（HCC）patients after transcatheter arterial che-moembolization（TACE）.Methods This study evaluated 1 7 male patients with HCC after TACE who were examined by both Gd-EOB-DTPA-MRI（3.0T）,enhanced-CT and conventional angiography at our institution.The interval of MR and CT examination was from 1 to 39 days （mean 14 days）,and the interval of MR examination and conventional angiography was from 1 to 44 days （mean 25 days）.Total of 69 lesions were selected according to m-RECIST,22 were more than 2.0 cm in diameter and 47 were less than 2.0 cm in diameter.We compared MR,CT and conventional angiography findings of each lesion by Friedman’s test.Mean-while,we also compared CT.And MR findings by Wilcoxon Signed Ranks Test to see if there was difference between these two mo-dalities.Results There was no difference among MR,CT and conventional angiography in lesions that were more than 2.0 cm in di-ameter （P〉 0.05,Friedman’s test）,but significant difference were found among these three modalities in lesions that were less than 2.0 cm in diameter.There was significant difference between MR and CT in lesions that were less than 2.0 cm in diameter （P〈0.001,Wilcoxon Signed Ranks Test）.Conclusion The present study demonstrated Gd-EOB-DTPA-MR imaging is getting better clinical value in evaluating HCC patients after TACE.Compared with CT examination,Gd-EOB-DTPA-MR examination had higher accuracy to detect small lesions of HCC after TACE.There was no difference,however,between the three methods in diagnosis of HCC lesions that were over 2.0 cm in diameter.

关 键 词：肝细胞特异性对比剂 肝细胞癌 经导管肝动脉化疗栓塞术 磁共振成像 

分 类 号：R735.7[医药卫生—肿瘤] R445.2[医药卫生—临床医学]