环状与线状分子结构钆螯合物增强MRI评价前列腺增生的对照研究

Comparison of cyclic and linear gadolinium chelates for enhancement MRI of prostate hyperplasia

目的分析MRI对比剂环状分子结构钆螯合物钆特酸葡胺对前列腺增生的增强效果。方法回顾性分析75例前列腺增生多期动态增强(DEC)和延迟期增强MRI表现,分为观察组[Gatedotera(钆特酸葡胺)组,20例]、对照组1[Magnevist(钆喷酸葡胺)组,15例]、对照组2[Consun(钆喷酸葡胺)组,16例]和对照组3[Omniscan(钆双胺)组,24例]。比较各组间前列腺增生结节基础信号强度、最大信号强度、增强幅度、达峰时间、DEC曲线上升斜率。以闭孔内肌信号强度、图像噪声为参考,比较延迟期增生结节实质强化程度、实质CNR、包膜强化程度、包膜CNR及包膜显示清晰度的差异。结果各组间达峰时间差异有统计学意义(F=3.812,P=0.014),观察组达峰时间明显短于对照组2(P=0.021),对照组2达峰时间明显长于对照组1(P=0.011)及对照组3(P=0.023);包膜强化程度及包膜CNR差异均有统计学意义(P均<0.05),观察组包膜强化程度明显高于对照组2(P=0.005)及对照组3(P=0.047),包膜CNR明显高于对照组1(P=0.016)、对照组2(P<0.001)及对照组3(P<0.001);且各组间MR增强扫描延迟期包膜显示清晰度差异有统计学意义(χ^2=127.86,P<0.010)。其余指标各组间总体及两两比较差异均无统计学意义(P均>0.05)。结论环状分子结构钆螯合物MRI对比剂增强效果与线状分子结构钆螯合物对比剂相仿,且显示包膜效果更优。

Objective To explore the enhancing effect of cyclic gadolinium chelates MRI contrast medium-Gatedotera of prostate hyperplasia.Methods MRI manifestations of dynamic enhancing contrast (DEC) and delay enhancing findings of 75 patients with prostate hyperplasia in central zone were analyzed retrospectively.According to contrast medium,the patients were divided into 4 groups,including observed group (Gatedotera,n =20),control group 1 (Magnevist,n =15),control group 2 (Consun,n =16) and control group 3 (Omniscan,n =24).The basic and maximal signal intensities,enhancing degree,time to peak and rising slope of DEC curve of prostate hyperplasia nodes were compared among groups.Taken musculi obturator internus and imaging noise as references,the enhancing degree and CNR of parenchyma and capsule of hyperplasia nodes were obtained and compared among groups,and the displaying of capsule of each group was also analyzed.Results Time to peak were significantly different among groups ( F =3.812,P =0.014),of observe group was clearly shorter than of control group 2 ( P =0.021),of control group 2 was clearly longer than of control group 1 ( P =0.011) and control group 3 ( P =0.023),respectively.The enhancing degrees and CNR of capsule were all statistical different among groups (all P <0.05),in observed group was clearly higher than in control group 2 ( P =0.005) and control group 3 ( P =0.047).CNR of capsule of observed group was clearly higher than that of control group 1 ( P =0.016),control group 2 ( P <0.001) and control group 3 ( P <0.001),respectively.In delay phase,the capsule displaying statistically different among groups (χ^2 =127.86,P <0.010).The differences of rest indexes among each group were not statistically significant for whole and pairwise comparison (all P >0.05).Conclusion The enhancing effect of cyclic gadolinium chelates was same as linear gadolinium chelates,while cyclic gadolinium chelates in capsule displaying was superior to linear gadolinium chelates.