肝转移瘤的检测：钆贝葡胺增强磁共振成像与超顺磁性氧化铁增强磁共振成像检查的比较

Detection of liver metastases: comparison of gadobenate dimeglumine-enhanced and ferumoxides-enhanced MR imaging examinations.

作者信息

del Frate Chiara, Bazzocchi Massimo, Mortele Koenraad J, Zuiani Chiara, Londero Viviana, Como Giuseppe, Zanardi Romeo, Ros Pablo R

机构信息

Institute of Radiology, Udine University, Policlinico Universitario a Gestione diretta, via Colugna 50, 33100 Udine, Italy.

出版信息

Radiology. 2002 Dec;225(3):766-72. doi: 10.1148/radiol.2253011854.

DOI:10.1148/radiol.2253011854

PMID:12461259

Abstract

PURPOSE

To compare gadobenate dimeglumine (Gd-BOPTA)-enhanced magnetic resonance (MR) imaging with ferumoxides-enhanced MR imaging for detection of liver metastases.

MATERIALS AND METHODS

Twenty consecutive patients known to have malignancy and suspected of having focal liver lesions at ultrasonography (US) underwent 1.0-T MR imaging with gradient-recalled-echo T1-weighted breath-hold sequences before, immediately after, and 60 minutes after Gd-BOPTA injection. Subsequently, MR imaging was performed with turbo spin-echo short inversion time inversion-recovery T2-weighted sequences before and 60 minutes after ferumoxides administration. All patients subsequently underwent intraoperative US within 15 days, and histopathologic analysis of their resected lesion-containing specimens was performed. Separate qualitative analyses were performed to assess lesion detection with each contrast agent. Quantitative analyses were performed by measuring signal-to-noise and contrast-to-noise ratios (CNRs) on pre- and postcontrast Gd-BOPTA and ferumoxides MR images. Statistical analyses were performed with Wilcoxon signed rank and Monte Carlo tests.

RESULTS

Sensitivity of ferumoxides-enhanced MR imaging was superior to that of Gd-BOPTA-enhanced MR imaging for liver metastasis detection (P <.05). Ferumoxides MR images depicted 36 (97%) of 37 metastases detected at intraoperative US, whereas Gd-BOPTA MR images depicted 30 (81%) metastases during delayed phase and 20 (54%) during dynamic phase. All six metastases identified only at ferumoxides-enhanced MR imaging were 5-10 mm in diameter. There was a significant increase in CNR between the lesion and liver before and after ferumoxides administration (from 3.8 to 6.8, P <.001) but not before or after Gd-BOPTA injection (from -4.8 to -5.5, P >.05).

CONCLUSION

Ferumoxides-enhanced MR imaging seems to be superior to Gd-BOPTA-enhanced MR imaging for liver metastasis detection.

摘要

目的

比较钆贝葡胺（Gd - BOPTA）增强磁共振（MR）成像与超顺磁性氧化铁增强MR成像对肝转移瘤的检测效果。

材料与方法

连续20例已知患有恶性肿瘤且超声检查（US）怀疑有肝脏局灶性病变的患者，在注射Gd - BOPTA前、注射后即刻及注射后60分钟接受1.0 - T MR成像，采用梯度回波T1加权屏气序列。随后，在注射超顺磁性氧化铁前及注射后60分钟，采用快速自旋回波短反转时间反转恢复T2加权序列进行MR成像。所有患者随后在15天内接受术中超声检查，并对切除的含病变标本进行组织病理学分析。分别进行定性分析以评估每种造影剂对病变的检测情况。通过测量Gd - BOPTA和超顺磁性氧化铁MR成像对比剂注射前后的信噪比和对比噪声比（CNR）进行定量分析。采用Wilcoxon符号秩检验和蒙特卡罗检验进行统计学分析。

结果

超顺磁性氧化铁增强MR成像检测肝转移瘤的敏感性优于Gd - BOPTA增强MR成像（P <.05）。术中超声检测到37个转移瘤，超顺磁性氧化铁MR图像显示其中36个（97%），而Gd - BOPTA MR图像在延迟期显示30个（81%）转移瘤，动态期显示20个（54%）。仅在超顺磁性氧化铁增强MR成像中发现的6个转移瘤直径均为5 - 10 mm。注射超顺磁性氧化铁前后病变与肝脏之间的CNR有显著增加（从3.8增至6.8，P <.001），而注射Gd - BOPTA前后无显著变化（从 - 4.8降至 - 5.5，P >.05）。