优化Gd-EOB-DTPA增强MRI不同延迟时间对肝细胞肝癌的诊断价值  

Optimizing the Diagnostic Value of Hepatocellular Carcinoma Based on Gd-EOB-DTPA Enhanced MRI with Different Delay Times

作　　者：李迅 蒋宇 LI Xun;JIANG Yu(Department of Radiology,Affiliated Hospital of Guilin Medical University,Guilin,Guangxi 541001,China)

机构地区：[1]桂林医学院附属医院放射科,广西桂林541001

出　　处：《影像研究与医学应用》2024年第16期38-42,共5页Journal of Imaging Research and Medical Applications

摘　　要：目的:确定不同肝功能状态下,肝细胞癌病灶检出的最佳肝胆期延迟时间。方法:回顾性分析桂林医学院附属医院2015年1月—2022年4月收治的64例肝癌患者的钆塞酸二钠(Gd-EOB-DTPA)增强影像资料及临床资料,根据临床资料及Child-Pugh评分将患者分为肝硬化Child-Pugh A(LCA)组,肝硬化Child-Pugh B(LCB)组与肝硬化Child-Pugh C(LCC)组。通过选择感兴趣区采集平扫,动脉期,门脉期,平衡期,延迟5、10、15、20 min的肝脏及病灶的信号强度,将肝实质与病灶的信号比定义为LLR。采用两因素重复测量方差分析处理数据。结果:延迟10、15、20 min时,Child-Pugh级别对LLR值的影响有统计学意义,此时LCA组的LLR值高于LCB组与LCC组,差异有统计学意义(P<0.05)。成对比较各时间点的LLR值显示,在LCA组中动脉期与延迟5、10 min的LLR差异无统计学意义(P>0.05),在LCB组中动脉期与延迟 5、10、15、20 min的LLR差异无统计学意义(P>0.05),在LCC组中动脉期与延迟15、20 min的LLR差异无统计学意义(P>0.05)。在3个不同肝功能组中延迟15 min与延迟20 min LLR的差异均无统计学意义(P>0.05)。结论:Gd-EOB-DTPA增强扫描在动脉期已能有效检出肝癌病灶。对于肝功能良好的患者,延迟扫描时间可缩短至15 min;而肝功能较差的患者,在肝胆期20 min的扫描中并未显示出比动脉期更佳的成像效果。Objective To optimize the hepatobiliary phase delay time(HBP-DT)of Gd-EOB-DTPA enhanced MRI imaging for identifying hepatocellular carcinoma(HCC)lesions occurring in different liver function statuses.Methods A retrospective analysis of the Gd-EOB-DTPA-enhanced imaging and clinical data from 64 patients diagnosed with liver cancer at Guilin Medical University Affiliated Hospital from January 2015 to April 2022 were selected.Based on clinical data and Child-Pugh scores,patients were categorized into groups liver cirrhosis with Child-Pugh A(LCA),liver cirrhosis with Child-Pugh B(LCB)and liver cirrhosis with Child-Pugh C(LCC).The signal intensity(SI)of the non-contrast,arterial,portal,equilibrium phase,HBP-DT of 5,10,15 and 20 min after injection of Gd-EOB-DTPA were collected by selecting regions of interest on liver parenchyma and HCC.The ratio of liver SI to HCC SI was defined as LLR.The data were analyzed by two-way repeated measures of ANOVA.Results At HBP-DT 10 min,LLR had a significant difference among different Child-Pugh groups,which in LCA were higher significant than those in LCB and LCC,as well as at HBP-DT 15 and 20 min(P<0.05).Paired comparison showed that LLR had no statistic difference at arterial phase,HBP-DT 5,10 min in LCA(P>0.05),as well as at arterial phase,HBP-DT 5,10,15,20 min in LCB(P>0.05)and at arterial phase,HBP-DT 15,20 min in LCC(P>0.05).LLR had no statistic difference at HBP-DT 15,20 min in all Child-pugh groups(P>0.05).Conclusion Gd-EOB-DTPA has a great ability to identify HCC at arterial phase.With good liver function,the delayed scan could be shortened to 15 minutes,and with poor liver function,extending the hepatobiliary phase scan to 20 minutes does not enhance the lesion conspicuity beyond that achieved in the arterial phase.

关 键 词：钆塞酸二钠 磁共振成像 肝胆期 延迟时间 

分 类 号：R445.2[医药卫生—影像医学与核医学]