Gd-EOB-DTPA增强MR对肝癌TACE术后局部肝功能损伤的评价  

Clinical Application of Gd-EOB-DTPA-Enhanced MRI in Evaluating Regional Hepatic Function Damage in Patients with HCC After TACE

作　　者：肖煜东[1] 周顺科[1] 刘军[1] 马聪[1] 张斌[1] 秦燕[1] 刘欢[1] 

机构地区：[1]中南大学湘雅二医院放射科,长沙410011

出　　处：《临床放射学杂志》2014年第12期1864-1867,共4页Journal of Clinical Radiology

摘　　要：目的探讨应用钆塞酸二钠（Gd-EOB-DTPA）增强MRI扫描对肝细胞癌（HCC）经导管动脉灌注化疗栓塞（TACE）术后局部肝功能损伤评价的价值。方法对15例HCC患者于TACE术后3~5天行MRI扫描,测量平扫和Gd-EOB-DTPA增强后20 min肿瘤周边（3 cm以内）组织以及正常肝组织的信噪比值（SNR）,并将二者进行对比。同时将可能的影响因素,如患者年龄、性别、肿瘤直径、肿瘤血供情况、Chind-Pugh分级和碘油栓塞量与结果进行相关分析。结果平扫,肿瘤周边组织的SNR值与正常肝组织的SNR差异无统计学意义（t=1.341,P=0.191）,Gd-EOB-DTPA增强后20 min,肿瘤周边组织的SNR值明显低于正常肝组织的SNR值（t=3.732,P〈0.001）。结论 Gd-EOB-DTPA增强MRI扫描是一种有效评价HCC患者TACE术后局部肝功能损伤的方法,对指导进一步治疗具有重要价值。Objective To discuss the clinical application of Gd-EOB-DTPA-enhanced MRI in evaluating regional liver function impairment in patients with hepatocellular carcinoma （HCC） after receiving transcatheter arterial chemoembolization （TACE） therapy. Methods Gd-EOB-DTPA-enhanced MRI was performed in 15 HCC patients three days after transeatheter arterial chemoembolization （TACE） treatment. The signal-to-noise ratio （SNR） was calculated in both healthy liver tissue region and peritumoral region （surrounded within 3em） before and 20rain after Gd-EOB-DTPA administration. The results were compared between the two regions. The possible influence factors, such as age, sex, tumor＇s diameter, blood supply of the tumor, Child-Pugh classification, the amount of lipiodol used in embolization, etc. were analyzed. The correlations between the possible influence factors and SNR were assessed using Pearson＇s correlation coefficient or Spearman rank correlation coefficient analysis. Results Plain MRI scanning showed that no statistically significant difference in SNR value existed between normal liver tissue and peritumoral tissue （t = 1. 341, P =0. 191 ）. Twenty minutes after Gd-EOB-DTPA administration, the SNR value of peritumoral tissue was significantly lower than that of the normal liver tissue （t = 3. 732, P 〈 0. 001 ）. Conclusion Gd-EOB-DTPA-enhanced MRI scanning is an effective means to evaluate the regional liver function impairment in HCC patients after TACE therapy.

关 键 词：磁共振成像 钆塞酸二钠 肝功能损伤 经导管动脉灌注化疗栓塞术 

分 类 号：R735.7[医药卫生—肿瘤]