Gd-BOPTA增强60 min再延迟扫描对小肝癌的诊断价值

Evaluation of delayed enhanced MRI with Gd-BOPTA in diagnosis of small HCC

目的探讨具有双相增强作用的磁共振对比剂钆贝葡胺(Gd-BOPTA),MRI增强后60min再延迟扫描对小肝癌(SHCC)的诊断价值。方法手术或穿刺病理证实为SHCC患者25例,采用Philips Intera 1.5T磁共振扫描仪。行SE序列T_1WI、FSE序列T_2WI及Gd-BOPTA快速动态增强多期扫描。Gd-BOPTA增强扫描采用静脉团注快速动态增强扫描,并在团注后20s、1min、5min及60min行THRIVE扫描。观察分析MRI平扫、Gd-BOPTA三期增强扫描及60 min再延迟扫描病灶的信号改变,并进行统计学处理。结果 25例患者,共发现SHCC病灶33个;对SHCC病灶的检出率,MRI平扫为75.8%(25/33),Gd-BOPTA三期增强为81.8%(27/33),Gd-BOPTA三期增强+60min再延迟扫描为96.9%(32/33)。Gd-BOPTA三期增强联合60min再延迟扫描对SHCC病灶的检出率明显优于Gd-BOP-TA三期增强,两者之间有统计学差异。结论 Gd-BOPTA增强后60 min再延迟扫描对小肝癌、尤其是乏血供的小肝癌具有较好的诊断价值。

Objective To investigate the diagnostic value of 60 minutes delayed enhanced MR imaging with Gd-BOPTA, a double-phasic magnetic resonance contrast agent, on the small hepatocellular cacinoma （SHCC）. Methods Twenty-five patients with surgery or pathologically proved SHCC underwent MR scan with PHILIPS Intera the 1.5T magnetic resonance scanner. The scan included SE T1WI, FSE T2WI and Gd-BOPTA dynamic enhanced MRI. Dynamic enhanced scanning were done 20 seconds, 1,5 and 60 minutes after Gd-BOPTA injection using THRIVE sequence. The signal intensity of lesions on non-enhanced, dynamic and 60 minutes delayed enhanced MR imaging were observed and analyzed. Results In 25 patients with SHCC, 33 lesions were found. The detection rate of non-enhanced, dynamic and 60 minutes delayed enhanced MR imaging were 75.8%, 81.8% and 96.9%, respectively. There was significant difference between 60 minutes delayed enhanced MR imaging and dynamic en- hanced MR imaging. Conclusion Gd-BOPTA has an important role in the diagnosis of SHCC, especially to find SHCC of deficient blood supply using 60 minutes delayed enhanced MR imaging.