钆塞酸二钠肝脏MRI多动脉期增强扫描评价肝血管解剖与CTA的对照研究  

Multi-arterial phase MRI of hepatic vessels using gadoxetic acid:intraindividual comparison of CTA

作　　者：袁元[1] 魏毅[1] 唐鹤菡[1] 邓莉萍[1] 陈国勇[1] 刘曦娇[1] 吴苾[1] 魏小程 杨汉城 宋彬[1] Yuan Yuan;Wei Yi;Tang Hehan;Deng Liping;Chen Guoyong;Liu Xijiao;Wu Bi;Wei Xiaocheng;Yang Hancheng;Song Bin(Department of Radiology,West China Hospital,Sichuan University,Chengdu 610041,China;MR Research Department,General Electric(China),Beijing 100176,China;MR Training Department,General Electric Medical Group,Beijing 100176,China)

机构地区：[1]四川大学华西医院放射科,成都610041 [2]通用电气(中国)磁共振科研部,北京100176 [3]通用电气医疗集团磁共振培训部,北京100176

出　　处：《中华放射学杂志》2019年第12期1086-1090,共5页Chinese Journal of Radiology

基　　金：国家自然科学基金(81771797)。

摘　　要：目的 探讨基于多动脉期三维容积快速动态成像(DISCO)技术在钆塞酸二钠增强MRI评价肝血管解剖中的应用价值.方法 前瞻性收集2017年8月至2019年5月四川大学华西医院经超声或CT检查怀疑肝脏局灶性恶性病变,行肝脏增强MRI(DISCO技术结合钆塞酸二钠增强MRI)和CTA扫描且检查间隔时间不超过2周的48例患者.对腹腔动脉(CA)、肝总动脉(CHA)、肝固有动脉(PHA)、左肝动脉(LHA)、右肝动脉(RHA)、左肝动脉第一分支(B-LHA)、右肝动脉第一分支(B-RHA)、脾动脉(SA)、胃左动脉(LGA)和胃十二指肠动脉(GDA)进行评分,采用Wilcoxon检验比较DISCO和CTA图像间的质量差异,采用Kruskal-Wallis H检验评价多支动脉之间的评分差异.结果DISCO图像上B-LHA的动脉评分为2(2,2),低于CTA图像的评分2(2,3),差异有统计学意义(Z=-3.138,P=0.002),其余9支动脉的评分差异均无统计学意义(P均>0.05).DISCO和CTA图像上10支动脉评分之间的差异均有统计学意义(χ^2值分别为244.740和225.574,P均<0.01),其中PHA和LHA、B-LHA和B-RHA之间在DISCO图像上差异有统计学意义(P均<0.05),但在CTA图像上差异无统计学意义(P均>0.05).结论 基于钆塞酸二钠增强DISCO肝脏MR血管成像中,肝动脉及主要分支的显示与CTA相比,其图像质量无明显差异,且无电离辐射,可为临床提供更全面的诊断信息.Objective To investigate the value of multi-arterial phase differential sub-sampling with cartesian ordering(DISCO)technique in the evaluation of hepatic vascular anatomy with gadolinium-ethoxybenzyl-diethylenetriamine pentaacetic acid(Gd-EOB-DTPA).Methods Forty-eight patients with suspected hepatic malignancy were prospectively enrolled and underwent both of Gd-EOB-DTPA enhanced DISCO MRI and CTA within two weeks.The hepatic arterial anatomy of two examination methods were evaluated by four-point scoring method.The arterial scores between DISCO and CTA images were compared by Wilcoxon test.The difference among multiple arterial scores of DISCO and CTA were compared by Kruskal-Wallis H test respectively.Results There was no difference of arterial scores in celiac artery,common hepatic artery,proper hepatic artery,left hepatic artery,right hepatic artery,first branch of right hepatic artery,splenic artery,left gastric artery and gastroduodenal artery between DISCO and CTA(P>0.05),but the arterial score of first branch of left hepatic artery[2(2,2)]was lower than that of CTA[2(2,3)](Z=-3.138,P=0.002).In the multiple comparison among different arteries,there were differences between PHA and LAH(P<0.05),B-LHA and B-RHA(P<0.05)in DISCO,but no difference was found in CTA(P>0.05).Conclusion The DISCO sequence with Gd-EOB-DTPA enhancement MRI can supply comparable image quality to CTA in hepatic artery and its main branches display,which has no ionizing radiation and can also provide more diagnostic information for clinic.

关 键 词：肝脏 磁共振成像 钆塞酸二钠 

分 类 号：R575[医药卫生—消化系统] R44[医药卫生—内科学]