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良性和恶性肝细胞肿瘤:钆喷酸葡胺三钠注射后在磁共振成像上肿瘤强化的评估

Benign and malignant hepatocellular tumors: evaluation of tumoral enhancement after mangafodipir trisodium injection on MR imaging.

作者信息

Coffin C M, Diche T, Mahfouz A, Alexandre M, Caseiro-Alves F, Rahmouni A, Vasile N, Mathieu D

机构信息

Department of Radiology, Hôpital Henri Mondor, 51 avenue du Maréchal de Lattre de Tassigny, F-94010 Créteil, France.

出版信息

Eur Radiol. 1999;9(3):444-9. doi: 10.1007/s003300050689.

Abstract

The aim of this work was to study the ability of mangafodipir trisodium (Mn-DPDP)-enhanced MR imaging in differentiating malignant from benign hepatocellular tumors. Eleven patients with pathologically proved hepatocellular carcinomas, six with focal nodular hyperplasias, and one with a single hepatocellular adenoma were examined by spin-echo and gradient-echo T1-weighted sequences before, 1 h after, and 24 h after intravenous injection of Mn-DPDP (5 micromol/kg). Quantitative analysis including enhancement and lesion-to-liver contrast-to-noise ratio, and qualitative analysis including the presence of a central area and a capsule were done on pre- and post-Mn-DPDP-enhanced images. Enhancement was observed in all the tumors with significant improvement (p < 0.05) in contrast-to-noise ratio 1 h after, and 24 h after intravenous injection of Mn-DPDP. There were no significant differences in the mean enhancement and the mean contrast-to-noise ratio (CNR) between benign and malignant tumors. No enhancement was seen within internal areas observed in 7 hepatocellular carcinomas, and in 5 focal nodular hyperplasias, and within capsules which were observed in 9 hepatocellular carcinomas. In our study, Mn-DPDP increased CNR of both benign and malignant tumors but did not enable differentiation between benign and malignant tumors of hepatocellular nature.

摘要

本研究旨在探讨锰福地匹三钠(Mn-DPDP)增强磁共振成像鉴别肝细胞良恶性肿瘤的能力。对11例经病理证实的肝细胞癌患者、6例局灶性结节性增生患者和1例单发肝细胞腺瘤患者,在静脉注射Mn-DPDP(5微摩尔/千克)前、注射后1小时及24小时,采用自旋回波和梯度回波T1加权序列进行检查。在Mn-DPDP增强前后的图像上进行包括强化及病变与肝脏对比噪声比的定量分析,以及包括中央区域和包膜存在情况的定性分析。所有肿瘤均可见强化,静脉注射Mn-DPDP后1小时及24小时对比噪声比有显著改善(p<0.05)。良性和恶性肿瘤之间的平均强化及平均对比噪声比(CNR)无显著差异。7例肝细胞癌、5例局灶性结节性增生的内部区域以及9例肝细胞癌的包膜内未见强化。在我们的研究中,Mn-DPDP增加了良性和恶性肿瘤的CNR,但无法鉴别肝细胞性良恶性肿瘤。

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