肝功能正常患者Gd-EOB-DTPA增强MRI肝胆期延迟时间的研究  

Gd-EOB-DTPA enhanced MR imaging: a study about the delay time of hepatobiliary phase in patients with normal liver function

作　　者：丁丁[1] 陆健[1] 黎美玲[1] 张学琴[1] 张涛[1] 杜圣[1] 徐晓莉[1] 姜吉锋[1] 杨雪飞[1] 

机构地区：[1]南通大学附属南通第三医院影像科,南通226001

出　　处：《磁共振成像》2015年第10期757-761,共5页Chinese Journal of Magnetic Resonance Imaging

基　　金：南通市科技局社会发展项目(编号:HS2013011);南通市卫生局青年基金课题(编号:WQ2014039)~~

摘　　要：目的评估钆塞酸二钠(gadolinium ethoxybenzyl diethylenetriaminepentaacetic acid,Gd-EOB-DTPA)增强磁共振成像(magnetic resonance imaging,MRI)延迟10 min的肝胆期是否能够满足肝功能正常患者肝脏局灶性病变的检出和诊断。材料与方法 38位存在肝脏局灶性病变的肝功能正常患者,经静脉注射Gd-EOB-DTPA后分别于25 s、60 s、180 s行MRI动态增强扫描,延迟10 min和20 min行肝胆期扫描。测量肝脏和竖脊肌的信号强度(signal intensity,SI),分别计算增强后肝脏和竖脊肌SI相对增加率、肝脏与竖脊肌SI比值、肝脏信号噪声比(signal to noise ratio,SNR)、肝胆期高信号和低信号病灶SNR及对比噪声比(contrast to noise ratio,CNR),记录Gd-EOB-DTPA经胆道排泄的时间,比较10 min与20 min肝胆期肝脏的信号强度和病灶的显示情况。结果注射Gd-EOBDTPA后,相对于动态增强,肝实质信号在10 min肝胆期明显增加,随后趋于稳定。10 min与20 min肝胆期之间,肝脏SI相对增加率、竖脊肌SI相对增加率及肝脏与竖脊肌SI比值差异均有统计学意义(P<0.05),肝脏SNR差异无统计学意义(P>0.05),低信号病灶SNR差异无统计学意义(P>0.05),高信号病灶SNR差异有统计学意义(P<0.05),低信号及高信号病灶CNR差异均无统计学意义(P>0.05)。26例注射Gd-EOB-DTPA后10 min胆道可见对比剂排泄,占68.42%。结论Gd-EOB-DTPA增强MRI延迟10 min的肝胆期能够满足肝功能正常患者肝脏局灶性病变的检出和诊断。Objective： To assess whether, in patients with normal liver function, a hepatobiliary delay time of 10 min after Gd-EOB-DTPA injection is sufficient for lesion detection and diagnosis. Materials and Methods： A total of 38 patients with normal liver function who has liver lesion were included in this study, and MRI was performed after intravenous Gd-EOB-DTPA, followed by dynamic contrast phases at 25 s, 60 s, 180 s and hepatobiliary phases at 10 min and 20 min. We＇ve measured the signal intensity（SI） of liver and erector spinae muscle, and then calculating liver ratio, muscle ratio, liver-muscle ratio, liver SNR, lesion SNR（hypo- and hyperintense lesions） and CNR（hypo- and hyperintense lesions）, recording the time of contrast agent excrete in bile ducts meanwhile. In all, we compared the differences of liver SI and the ability to show lesion＇s information between 10 min and 20 min hepatobiliary phases. Results： Following enhancement, liver SI increased significantly up to 10 min, and subsequently stabilized. Differences of liver ratio, muscle ratio and liver-muscle ratio between hepatobiliary phases of 10 min and 20 min were statistically significant（P〈0.05）. There was no statistical difference of liver SNR between hepatobiliary phases of 10 min and 20 min（P〉0.05）. Difference of hyperintense lesions SNR between 10 min and 20 min hepatobiliary phases was statistically significant（P〈0.05）, but hypointense lesions SNR wasn＇t（P〉0.05）. Neither hypo- nor hyperintense lesions CNR has statistical difference between 10 min and 20 min hepatobiliary phases（P〉0.05）. Besides, biliary contrast agent excretion was first observed after 10 min in 26 patients（68.42%）. Conclusion： A hepatobiliary delay time of 10 min after Gd-EOB-DTPA injection is sufficient for lesion detection and diagnosis in patients with normal liver function.

关 键 词：钆塞酸二钠 磁共振成像 增强 肝胆期 

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]