钆塞酸二钠增强MRI肝胆期延迟时间及临床应用研究

Study on the delay time of hepatobiliary phase of feasibility of gadoxetate disodium enhanced MRI and its clinical application

[目的]探讨钆塞酸二钠(Gd-EOB-DTPA)增强MRI肝胆期延迟时间及其在临床应用中的可行性.[方法]回顾性分析行Gd-EOB-DTPA增强MRI检查的68例患者临床资料,其中对照组16例,肝炎组52例;肝炎组中肝细胞肝癌病灶42个,硬化结节病灶15个,共计57个病灶.静脉注射给予对比剂后行动态增强扫描,在延迟20 min、1、2 h时行肝胆期扫描.测量肝胆期肝脏、竖脊肌和病灶的信号强度(SI),比较两组3个时相时肝脏信号噪声比(SNR)、肝脏与竖脊肌SI比值及肝炎组3个时相间的病灶对比噪声比(CNR).记录所有患者肝胆期胆囊全部充盈所需时间及肝内胆管显影情况.[结果]对照组和肝炎组3个时相肝脏SNR、肝脏与竖脊肌SI比值间差异均无统计学意义(P>0.05);肝炎组3个时相时的病灶CNR间差异均无统计学意义(P>0.05).两组肝脏SNR间比较见延迟20 min时差异无统计学意义(P>0.05),延迟1、2 h时差异均有统计学意义(P<0.05).两组3个时相的肝脏与竖脊肌SI比值间差异均有统计学意义(P<0.05).两组胆囊显示率间比较见延迟20 min时差异有统计学意义(P=0.012),延迟1、2 h时差异均无统计学意义(P=0.531).两组3个时相的肝内胆管显影评分间差异均无统计学意义(P>0.05).[结论]Gd-EOB-DTPA增强MRI延迟20 min至2 h之间的肝胆期图像均可满足影像学诊断要求,可用于病变的检出及肝脏、胆道功能的评估.

OBJECTIVE To explore the feasibility of gadoxetate disodium(Gd-EOB-DTPA)enhanced MRI in the delay time of hepatobiliary phase and its clinical application.METHODS The clinical data of 68 patients who underwent Gd-EOB-DTPA enhanced MRI were retrospectively analyzed.There were 16 cases in the control group and 52 cases in the hepatitis group.In the hepatitis group,there were 42 hepatocellular carcinoma lesions and 15 sclerosis nodules lesions,57 lesions in total.Dynamic enhanced scanning was performed after intravenous injection of contrast agent,and hepatobiliary phases scanning was performed after a delay of 20 min,1 and 2 h.The signal intensity(SI)of liver,erector spinae and lesions in hepatobiliary phase was measured.Signal to noise ratio(SNR)of liver and SI ratio of liver to erector spinae were compared between the two groups at the three phases,and contrast to noise ratio(CNR)of lesion at the three phases in the hepatitis group was compared.The time required for full gallbladder filling and intrahepatic bile duct development in all patients were recorded.RESULTS There were no statistical significance in liver SNR,SI ratio of liver to erector spinae at the three phases between the two groups(P>0.05).There were no statistical significance in CNR between the three phases in the hepatitis group(P>0.05).There was no significant difference in liver SNR between the two groups after 20 min delay(P>0.05),the differences were statistically significant after 1 and 2 h delay between two groups(P<0.05).The SI ratio of liver to erector spinae of the two groups was statistically significant at the three phases(P<0.05).There was statistical differences in the gallbladder display rate between the two groups after 20 min delay(P=0.012),while there were no statistical differences after 1 and 2 h delay(P=0.531).There was no statistical differences in intrahepatic bile duct development score at the three phases between the two groups(P>0.05).CONCLUSION Gd-EOB-DTPA enhanced MRI images of hepatobiliary phase with a delay of 20 min to 2 h can meet the imaging diagnostic requirements,and can be used for the detection of lesions and the evaluation of liver and biliary tract function.