钆贝葡胺延时1h肝胆期扫描对肝脏良恶性病灶的信号分析价值

Gd-BoPTA scan of one-hour delayed hepatobiliary phase of benign and malignant lesions of the liver: value of signal analysis

目的观察钆贝葡胺注射液(gadobenate dimeglumine injection,Gd-BOPTA)作为磁共振的特异性对比剂,在1h延时肝胆期肝脏病灶的信号强度,分析良恶性病灶的信号特征及与病理的关系。方法可疑肝脏病变50例,共70个肝脏病灶行MR平扫、BOPTA动态增强及1 h延时并2周内经穿刺活检病理诊断或手术证实。记录各种病灶在T1平扫及1 h肝胆期的信号强度,计算各种病灶的信噪比(SNR)及对噪比(CNR)并做统计学分析。结果 1 h延时后,97.8%的恶性病灶表现为低信号,40%的良性病灶表现为低信号,二者有统计学意义(P<0.05)。SNR、CNR值存在不同程度的差异。结论典型的恶性病灶的组织学特征反映出的钆贝葡胺核磁增强肝胆期低信号改变,而一些良性病灶由于内部结构的原因,也可表现为低信号,鉴别诊断依然存在困难。

Objective To observe the images with injection of Gd-BOPTA（gadobenate dimeglumine,Gd-BOPTA injection,multihance） as the dual phase MRI contrast agent and after the acquisition of one-hour delayed hepatobiliary-phase images and to analyze signal attenuation and characteristics in both benign and malignant liver lesions after intravenous bolus administration of Gd-BOPTA.Methods Fifty patients were suspected of having liver lesions.The seventy liver lesions of theirs underwent MRI scan and were confirmed by biopsy pathological diagnosis or operation in two weeks.The lesion to liver contrast/noise ratio（CNR） and signal/noise ratio（SNR）were calculated both in benign and malignant liver lesions.Results After one-hour delay,97.8% of the malignant lesions and 40% of the benign lesions showed low signal.There was statistically significant difference between the two groups（P0.05）.SNR and CNR illustrated some difference in benign and malignant lesions.Conclusions Although the hypointense signal in the hepatobiliary-phase of the Gd-BOPTA enhanced magnetic resonance imaging was typically a histological feature of malignant lesions in liver lesions,some of the benign lesions also showed a similar signal due to the internal structure.Differential diagnosis betweem benign liver lesions and malignant ones remains difficult.