结直肠癌肝转移癌钆塞酸二钠(Gd-EOB-DTPA)增强MRI肝胆期特征  

Features of hepatic metastases from colorectal cancer on hepatobiliary phase of gadolinium-ethoxybenzyl-diethylenetriamine pentaacetic acid(Gd-EOB-DTPA)enhanced MRI

作　　者：郝雪佳 谷小磊 曹敏 李晓婷[1] 高凤霄[2] 崔湧[1] 孙应实[1] HAO Xuejia;GU Xiaolei;CAO Min;LI Xiaoting;GAO Fengxiao;CUI Yong;SUN Yingshi(Department of Radiology,Peking University Cancer Hospital&Institute,Key Laboratory of Carcinogenesis and Translational Research,Beijing 100142,China;Department of CT/MRI,Xingtai People's Hospital,Xingtai 054001,China)

机构地区：[1]北京大学肿瘤医院暨北京市肿瘤防治研究所医学影像科恶性肿瘤发病机制及转化研究教育部重点实验室,北京100142 [2]邢台市人民医院CT/MRI科,河北邢台054001

出　　处：《中国医学影像技术》2021年第9期1347-1352,共6页Chinese Journal of Medical Imaging Technology

基　　金：国家自然科学基金(61520106004)。

摘　　要：目的观察结直肠癌肝转移癌钆塞酸二钠(Gd-EOB-DTPA)增强MRI肝胆期特征。方法纳入57例结直肠癌肝转移患者(共131个转移灶),观察病灶在各序列MRI中的信号表现及其增强特征;测量转移灶动脉期、肝胆期直径,计算转移灶与肝实质信号强度比(SIR)等。以Kappa检验及组内相关系数(ICC)评价观察者间一致性,比较肝胆期呈现不同强化特征的转移癌之间表观弥散系数(ADC)的差异。结果观察者间判断各序列信号特征及测量定量参数结果的一致性均良好(ICC均≥0.75,P均<0.05)。转移癌T1WI均呈低信号;T2WI均呈高信号,其中31.30%(41/131)靶样外观,9.16%(12/131)呈反靶样外观,23.66%(31/131)呈不均匀高信号,35.88%(47/131)呈均匀高信号。增强动脉期79.39%(104/131)转移癌呈环形强化,15.27%(20/131)呈不均匀强化,5.34%(7/131)呈均匀强化;肝胆期21.37%(28/131)呈靶样强化,41.22%(54/131)呈反靶样强化,26.72%(35/131)呈不均匀强化,10.69%(14/131)呈均匀强化。62.60%(82/131)转移癌周围肝实质增强,68.70%(90/131)SIR≥0.5。肝胆期呈现不同强化特征的转移癌之间ADC差异无统计学意义(P<0.05)。结论结直肠癌肝转移癌Gd-EOB-DTPA增强MRI肝胆期表现多样,以靶样强化或反靶样强化较为常见。Objective To observe features of hepatic metastases from colorectal cancer on hepatobiliary phase of gadolinium ethoxybenzyl diethylenetriamine pentaacetic acid(Gd-EOB-DTPA)enhanced MRI.Methods A total of 57 colorectal cancer patients with 131 metastases were enrolled.The signal features and enhancement patterns of lesions on different MRI sequences were observed.The diameters of metastases on arterial and hepatobiliary images were measured,and the signal intensity ratios(SIR)between metastases and liver parenchyma were calculated in the hepatobiliary phase.Kappa test and intra-class correlation coefficient(ICC)were used to evaluate the consistency of observers.The apparent diffusion coefficient(ADC)of lesions with different enhancement patterns in hepatobiliary phase were compared.Results Good intra-observer agreement was detected of results both of signal features and quantitative parameters(all Kappa≥0.75,P<0.05).All metastases showed low signals on MR T1WI and high signals on T2WI.There were 31.30%(41/131)lesions showed target appearance on T2WI,9.16%(12/131)were found with reversed target appearance,23.66%(31/131)with heterogeneously high signals and 35.88%(47/131)with homogeneously high signals.Peripheral enhancement was observed in 79.39%(104/131),heterogeneous enhancement in 15.27%(20/131)and homogeneous enhancement in 5.34%(7/131)metastases during arterial phase,while target appearance enhancement was noticed in 21.37%(28/131),reversed target appearance enhancement in 41.22%(54/131),heterogeneous enhancement in 26.72%(35/131)and homogeneous enhancement in 10.69%(14/131)during hepatobiliary phase.Peripheral hepatic parenchyma enhancements were found in 62.60%(82/131),and SIR≥0.5 was observed in 68.70%(90/131)metastases.No significant difference of ADC was found among lesions with different enhancement patterns during hepatobiliary phase.Conclusion Imaging features of hepatic metastases from colorectal cancer in hepatobiliary phase of Gd-EOB-DTPA enhanced MRI were various,among which target appearance

关 键 词：结直肠肿瘤 肿瘤转移 对比剂 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]