MRI钆对比剂:环状螯合物和链状螯合物在乳腺纤维腺瘤增强效能的对比研究

Comparative Study of Enhanced Performance in Breast Fibroadenoma that used MR Gadolinium Contrast Agent: Cyclic Chelate or Chain Chelate

目的对比研究MRI钆对比剂:钆特酸葡胺,钆喷酸葡胺(马根维显)、钆双胺、钆喷酸双葡甲胺(康臣)对乳腺纤维腺瘤增强效能。方法收集本院经病理确诊的120例乳腺纤维腺瘤的MRI资料,随机分为4组,每组30例,钆对比剂分别使用钆特酸葡胺、马根维显、钆双胺、钆喷酸双葡甲胺。MRI动态增强采用快速小角度激发三维成像(Flash-3D)抑脂T1WI序列。记录各个病例每个时期的MRI SI值,并算出最大对比增强率(MCER)。SI值比较采用单因素方差分析,MRCE比较采用Kruskal-Walls检验,得出P值,以P﹤0.05认为差异有统计学意义。统计使用对比剂后的药物不良反应。结果使用钆特酸葡胺纤维腺瘤的TIC曲线持续上升型26例,上升平台型4例。使用马根维显纤维腺瘤的TIC曲线持续上升型24例,上升平台型6例。使用钆双胺纤维腺瘤的TIC曲线持续上升型28例,上升平台型2例。使用钆喷酸双葡甲胺纤维腺瘤的TIC曲线持续上升型28例,上升平台型2例。经过统计学分析,各组病灶的长径、短径、起始SI值、终末SI值、MRCE、SNR、CNR差别均无统计学意义。120例患者均未出现药物不良反应。结论钆特酸葡胺的分子类型是大环状,马根维显、钆双胺、钆喷酸双葡甲胺的分子类型是线性,基于分子结构方面考虑,钆特酸葡胺要优于其余三种钆造影剂。通过本研究,对于乳腺纤维腺瘤的MRI动态增强,钆特酸葡胺、马根维显、钆双胺、钆喷酸双葡甲胺在增强效能方面无明显差异,均未出现药物不良反应。

Objective Comparative study of MRI gadolinium contrast agent enhancement efficacy： gadoterate meglumine（cyclic chelate）, gadopentetate（chain chelate）, gadodiamide（chain chelate）, gadopentetate dimeglumine（chain chelate） in breast fibroadenoma. Methods Collected 120 cases MRI datas of breast fibroadenoma confirmed by pathology, were randomly divided into 4 groups, each group of 30 cases, gadolinium contrast agent were used gadoterate meglumine, gadopentetate, gadodiamide or gadopentetate dimeglumine. MRI dynamic enhancement using fast small angle excitation three-dimensional imaging lipid-suppressing T1 WI sequence. The MRI signal strength values of each case were recorded and the maximum contrast enhancement rate（MCER） was calculated. SI values were compared using single factor analysis of variance, MRCE comparison using Kruskal-Walls test. The adverse effects of contrast agents were recorded. Results The group of used gadoterate meglumine, TIC curve includes 26 cases of inflow type and 4 cases of ascending platform type. The group of used gadopentetate, the types of TIC curves were 24 cases of inflow type and 6 cases of ascending platform type. The group of used gadoterate meglumine, TIC curve includes 28 cases of inflow type and 2 cases of ascending platform type. The group of used gadopentetate, the types of TIC curves were 28 cases of inflow type and 2 cases of ascending platform type. After statistical analysis, the difference in each group of the length and short diameter of tumor, the initial SI value, the end SI value, the MRCE, the SNR and CNR were not statistically significant. No adverse reactions occurred in 120 patients. Conclusion The molecular type of gadoterate meglumine is cyclic, and the molecular type of gadopentetate, gadodiamide, and gadopentetate dimeglumine is linear. Based on the molecular structure, gadoterate meglumine is superior to the other three kinds of gadolinium contrast agents. In this study, there was no significant difference in enhancement performance between those four kinds gadolinium contrast agents, and no adverse reactions occurred.