国内外肝胆特异性对比剂钆塞酸二钠的临床应用对比研究  

A comparative study on the clinical application of domestic hepatobiliary specific contrast agent and foreign hepatobiliary specific contrast agent Gd-EOB-DTPA

作　　者：魏焕焕 付芳芳[2] 杨燕 白岩[2] 魏巍[2] 余璇 高海燕 陈丽娟 王梅云[2] WEI Huanhuan;FU Fangfang;YANG Yan;Bai Yan;WEI Wei;YU Xuan;GAO Haiyan;CHEN Lijuan;WANG Meiyun(Department of Imaging,People's Hospital of Zhengzhou University,Zhengzhou 450003,China;Department of Imaging,Henan Provincial People's Hospital,Zhengzhou 450003,China)

机构地区：[1]郑州大学人民医院影像科,郑州450003 [2]河南省人民医院影像科,郑州450003

出　　处：《磁共振成像》2023年第1期89-93,共5页Chinese Journal of Magnetic Resonance Imaging

基　　金：河南省科技攻关项目(编号:212102310689)。

摘　　要：目的探讨国产与国外肝胆特异性对比剂钆塞酸二钠(gadolinium-ethoxybenzyl-diethylenetriaminepentaacetic acid,Gd-EOB-DTPA)的对比分析及在肝功能分级评估中的价值。材料与方法回顾性分析2018年6月至2020年7月经病理证实或临床诊断为慢性肝病患者的影像及临床资料。根据使用对比剂的不同将患者分为两组并对各组的动脉期、门静脉期、平衡期及肝胆期的MRI图像进行质量评估。测量增强前的相对比率(signal intensity before enhancement,SI_(pre))与肝胆期的相对比率(signal intensity in hepatobiliary phase after contrast enhancement,SI_(post)),计算对比增强指数(contrast enhancement index,CEI),CEI=SI_(post)/SI_(pre)。对以上所得数据通过SPSS软件进行统计学分析。结果两种对比剂MRI图像质量评估无显著性差异,两名评估者的一致性较高。在肝功能Child-Pugh A、Child-Pugh B分级时,国产Gd-EOB-DTPA对比剂平均CEI分别为1.28~1.87(1.40±0.14)、1.00~1.28(1.15±0.07),Child-Pugh A组与Child-Pugh B组的CEI存在显著性差异(P<0.001);国外Gd-EOB-DTPA对比剂平均CEI分别为1.30~1.67(1.40±0.09)、1.00~1.29(1.18±0.08),Child-Pugh A组与Child-Pugh B组的CEI存在显著性差异(P<0.001)。两组对比剂的CEI在相同肝功能Child-Pugh分级时无显著性差异(所有P>0.05);两组的CEI随着肝功能的减低均呈降低趋势。结论国产Gd-EOB-DTPA对比剂与国外Gd-EOB-DTPA对比剂在肝脏疾病MRI增强图像中表现高度相似,诊断效能无显著差异。国产Gd-EOB-DTPA对比剂MRI增强图像的主观性项目评估与定量参数评价具有较好的分析结果,可为慢性肝病患者的肝功能评估提供重要的临床价值。Objective:To investigate the comparative analysis of different hepatobiliary specific contrast agents and their value in liver function grading evaluation.Materials and Methods:The imaging data of patients with pathologically confirmed or clinically diagnosed chronic liver disease in Henan Provincial People's Hospital from June 2018 to July 2020 were retrospectively analyzed.A total of 162 patients were included and divided into two groups according to different contrast medium,including 81 patients who underwent domestic contrast enhancement and 81 patients who underwent originator contrast enhancement.The quality of MRI images in arterial phase,portal venous phase,equilibrium phase and hepatobiliary phase was assessed in both groups.The contrast enhancement index(CEI)was calculated by measuring the relative ratio of the unenhanced masked image(SI_(pre))to the relative ratio of the hepatobiliary specific phase after enhancement(SI_(post)),CEI=SI_(post)/SI_(pre).The clinical data of all patients were collated and analyzed for Child-Pugh classification of liver function,the difference in CEI between domestic contrast medium and original contrast medium was assessed and the correlation between CEI of the two contrasts medium and Child-Pugh classification of liver function was explored,respectively.Results:There was no significant difference in MRI images quality assessment between the two contrasts medium,and the consistency between the two assessors was high.The mean CEI of domestic gadolinium-ethoxybenzyl-diethylenetriaminepentaacetic acid(Gd-EOB-DTPA)contrast medium in Child-Pugh classification A and B of liver function was 1.28-1.87(1.40±0.14)and 1.00-1.28(1.15±0.07),and there was a significant difference in the CEI between Child-Pugh A group and Child-Pugh B group(P<0.001).The mean CEI of originator contrasts medium Gd-EOB-DTPA was 1.30-1.67(1.40±0.09)and 1.00-1.29(1.18±0.08),and there was a significant difference in the CEI between Child-Pugh A group and Child-Pugh B group(P<0.001).There was no significan

关 键 词：肝 肝功能 肝胆特异性对比剂 钆塞酸二钠 对比分析 对比增强指数 磁共振成像 

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