Gd-EOB-DTPA增强扫描前后T_2 WI对肝脏局灶性病变检出情况的比较  

Comparison of T_2-weighted MR image in detection of focal liver lesions before and after administration of Gd-EOB-DTPA

作　　者：蔡华崧[1] 伍玲[1] 周丽莎[1] 罗宴吉[1] 翟凤仪[1] 冯仕庭[1] 李子平[1] 郑可国[1] 

机构地区：[1]中山大学附属第一医院医学影像科,广州510080

出　　处：《新医学》2015年第10期661-667,共7页Journal of New Medicine

基　　金：国家自然科学青年基金项目(81000626);广东省自然科学基金(S2013010016004);广东省科技计划项目(2014A020212125);珠江科技新星专项(2012J2200084)

摘　　要：目的比较肝脏局灶性病变患者行MRI检查时于注射钆塞酸二钠(Gd-EOB-DTPA)前、后进行T2加权像(T2WI)扫描对病灶检出情况的差异。方法比较84例肝脏局灶性病变(包括肝细胞癌、局灶性结节增生、肝转移瘤及肝血管瘤)患者Gd-EOB-DTPA增强扫描前、后进行T2WI扫描的病灶检出情况、病灶信号噪声比及病灶-肝脏噪声比。结果 Gd-EOB-DTPA增强扫描后T2WI的肝细胞癌、局灶性结节增生、肝转移瘤及肝血管瘤的检出评分均稍高于增强扫描前T2WI,但比较差异均无统计学意义(P均>0.05)。Gd-EOB-DTPA增强扫描前肝细胞癌、局灶性结节增生、肝转移瘤及肝血管瘤的病灶信号噪声比依次为7.65±0.35、6.13±0.74、7.83±0.49、16.69±0.52,增强扫描后依次为7.27±0.38、5.78±0.70、7.32±0.45、12.37±0.42,比较差异均有统计学意义(P均<0.001);Gd-EOB-DTPA增强扫描前肝细胞癌、局灶性结节增生、肝转移瘤及肝血管瘤的病灶-肝脏噪声比依次为2.14±0.37、1.02±0.65、2.33±0.51、13.07±0.49,增强扫描后依次为3.46±0.35、2.06±0.61、4.28±0.47、9.11±0.52,比较差异均有统计学意义(P均<0.001)。结论对于肝细胞癌、局灶性结节增生、肝转移瘤及肝血管瘤患者,在接受MRI检查时,于Gd-EOB-DTPA增强扫描后行T2WI扫描对病灶的检出无明显影响,可在上述病变动态增强扫描后进行T2WI以节省扫描时间。Objective To compare the T2-weighted image（ T2 WI） in the detection of focal hepatic lesions before and after administration of gadolinium ethoxybenzyl diethylenetriamine pentaacetic acid（ GdEOB-DTPA）. Methods Eighty four patients diagnosed with focal liver lesions（ hepatocellular carcinoma,focal nodular hyperplasia,liver metastasis neoplasm and hepatic hemangioma） underwent T2 WI. The detection capability,signal-to-noise ratio（ SNR） and lesion-liver contrast to noise ratio（ CNR） before and after administering Gd-EOB-DTPA were statistically compared. Results The detection scores of hepatocellular carcinoma,focal nodular hyperplasia,liver metastasis neoplasm and hepatic hemangioma after Gd-EOB-DTPA-enhanced T2 WI were only slightly higher than those before the administration of Gd-EOB-DTPA without statistical significance（ all P 0. 05）. The SNR of hepatocellular carcinoma,focal nodular hyperplasia,liver metastasis neoplasm and hepatic hemangioma before Gd-EOB-DTPA-enhanced T2 WI were 7. 65 ± 0. 35,6. 13 ± 0. 74,7. 83 ±0. 49 and 16. 69 ± 0. 52,significantly higher compared with 7. 27 ± 0. 38,5. 78 ± 0. 70,7. 32 ± 0. 45 and12. 37 ± 0. 42 after Gd-EOB-DTPA-enhanced T2WI（ all P 0. 001）. The CNR of hepatocellular carcinoma,focal nodular hyperplasia,liver metastasis neoplasm and hepatic hemangioma before Gd-EOB-DTPA-enhanced T2 WI were 2. 14 ± 0. 37,1. 02 ± 0. 65,2. 33 ± 0. 51 and 13. 07 ± 0. 49,significantly lower than 3. 46 ± 0. 35,2. 06 ± 0. 61,4. 28 ± 0. 47 and 9. 11 ± 0. 52 following Gd-EOB-DTPA-enhanced T2WI（ all P 0. 001）. Conclusion Gd-EOB-DTPA-enhanced T2 WI exerted no apparent effect upon the detection of focal liver lesions in patients diagnosed with hepatocellular carcinoma,focal nodular hyperplasia,liver metastasis neoplasm and hepatic hemangioma,so T2 WI can be performed following Gd-EOB-DTPA-enhanced scan to shorten the time of examine.

关 键 词：钆塞酸二钠 T2加权像 磁共振 

分 类 号：R445.2[医药卫生—影像医学与核医学] R575[医药卫生—诊断学] R735.7[医药卫生—临床医学]