Feridex增强MRI对小肝癌的检出价值

The Value of Feridex Enhanced MR Imaging in Detection of Small Hepatocellular Carcinoma

目的 通过与常用造影剂Gd DTPA的比较来评价新型造影剂Feridex对小肝癌的检出和定性诊断能力。方法 5 3个病例 10 7个疑似小肝癌病变首日行平扫及Gd DTPA的动态增强扫描 ,次日行Feridex增强扫描 ,对照病理及临床随访证实结果 ,比较平扫联合Gd DTPA动态增强扫描与平扫联合Feridex增强扫描的病灶检出率和定性诊断率。结果 Feridex增强扫描小肝癌信号保持不变 ,而良性肝占位的信号随肝实质降低。平扫联合Feridex增强扫描的病灶检出率较平扫联合Gd DTPA增强扫描的略高 ,但两者的定性诊断率在统计学上相差不显著。结论 Feridex增强的原理、强化方式直至临床应用方法、特点与Gd DTPA均完全不同 ,两者互相补充和印证 ,Feridex增强扫描不仅可进一步提高Gd DTPA动态增强扫描的检出率 ,而且可进一步帮助定性诊断。

Objective Compared with Gd DTPA enhanced MR images, the efficacy of Feridex in detection of small hepatocellular carcinomas (sHCC) was evaluated. Methods Fifty three patients with 107 doubtful sHCC underwent plain and Gd DTPA dynamic enhanced MR images in the first day and Feridex enhanced MR images in the second day. Correlated with the findings from histopathologic and clinical follow up comfirmed, the rate of detection of sHCC and the accuracy of characteristic diagnosis of the two contrast media were compared. Results Feridex cause a signal decrease in benign lesions but not in sHCC. For plain combining Feridex enhanced MRI, the rate of detection of sHCC was slightly higher than that of plain combining Gd DTPA enhanced MRI, but there is no statistical significance in the accuracy of characteristic diagnosis. Conclusion The theory and mode of Feridex enhancement and even the way of Feridex appliance are quite different from that of Gd DTPA. The two can complement and confirm each other. Feridex enhanced MRI can not only improve the detection rate of Gd DTPA enhanced MRI, but also help in characteristic diagnosis.