钆塞酸二钠和钆喷酸葡胺肝脏多期动态增强呼吸伪影对比研究

A comparative study of respiratory motion artifacts caused by intravenous administration of Gd-EOB-DTPA and Gd-DTPA in dynamic contrast enhanced MR imaging of the liver

目的:比较静脉注射钆塞酸二钠(Gd-EOB-DTPA)和钆喷酸葡胺(Gd-DTPA)的动脉期呼吸伪影,寻求减少Gd-EOB-DTPA动脉期呼吸伪影的可能方案。方法:搜集在1年内行Gd-EOB-DTPA和Gd-DTPA磁共振动态增强扫描的患者75例,由两位有经验的磁共振医师采用盲法对两种对比剂扫描方案的动脉期、门脉期及延迟期图像采用5分法评分,以≤3分定义为中重度伪影。两种对比剂扫描方案的呼吸伪影比较采用Wilcoxon秩和检验和配对卡方检验。结果:Gd-EOB-DTPA组发生动脉晚期呼吸伪影的比例明显高于Gd-DTPA组(分别为49.3%和6.7%,Z=-5.058,P<0.001),其中中重度伪影的比例亦明显高于Gd-DTPA(分别为33.33%和2.67%,χ2=21.04,P<0.001);而Gd-EOB-DTPA组动脉早期出现呼吸伪影和中重度呼吸伪影的比例与Gd-DTPA组差异无统计学意义(Z=-1.513,P=0.130;χ2=0.25,P=0.625)。结论:静脉注射Gd-EOB-DTPA较Gd-DTPA更易引起动脉期伪影,减少单期屏气时间和采用动脉期监测技术可能提高Gd-EOB-DTPA动脉期采集的图像质量。

Objective：To compare the levels of respiratory motion artifacts related to the intravenous administration of Gd-EOB-DTPA with that of Gd-DTPA during MR multi-phase scan,and to seek a feasible solution to decrease respiratory artifacts on arterial phase after administration of Gd-EOB-DTPA.Methods：75patients underwent MR dynamic examinations with Gd-DTPA and Gd-EOB-DTPA administration were collected and studied retrospectively in the last one year period.Respiratory motion artifacts on dynamic scan（i.e.,arterial,portal,or late phase）were blindly rated by two experienced radiologists using a five-point scale,in which 3points or less indicate moderate to severe artifacts.Statistical analysis of the rated results was performed by using Wilcoxon test or χ^2 test.Results：Significantly higher ratio of respiratory motion artifacts（49.3% versus 6.7%,Z=-5.058,P〈0.001）and a higher ratio of moderate to severe artifacts（33.33% vs 2.67%,χ^2=21.04,P〈0.001）were observed on late arterial phase after Gd-EOB-DTPA administration,in comparison to those of Gd-DTPA.However,respiratory artifacts were not observed on early arterial phase（Z=-1.513,P=0.130andχ^2=0.25,P=0.625）between these two contrast media.Conclusions：Intravenous administration of Gd-EOB-DTPA causes more arterial phase artifacts than that caused by Gd-DTPA.Image quality on arterial phase can be improved by reducing breath hold time of each scan and by use of arterial monitoring.