Beziat C, Pilleul F, Yzebe D, Lombard-Bohas C, Mercier C, Valette P J
Service de Radiologie digestive, Hôpital Edouard Herriot, Lyon.
J Radiol. 2004 Mar;85(3):307-11. doi: 10.1016/s0221-0363(04)97583-x.
To compare MRI of the liver with mangafodipir trisodium (MnDPDP) and computed tomography with intravenous contrast media in the follow-up of liver metastases in patient on chemotherapy for colorectal carcinoma.
This was a prospective study with patients on chemotherapy for liver metastases from colorectal cancer. Patients underwent both contrast-enhanced helical CT using 2 cc/kg contrast at 3 cc/sec and mangafodipir trisodium-enhanced MR imaging at 1.5 T using 2-3 cc/min contrast at 5 micro mol/kg within a two week interval. Two experienced radiologists independently reviewed all scans in a blinded fashion and recorded image quality as well as presence and number of liver lesions. Statistical analysis was performed using the wilcoxon signed rank test.
All examinations were of good quality. A total of 71 lesions were detected at CT, with 69 lesions consistent with metastases and 2 lesions consistent with cysts. A total of 98 lesions were detected at MRI, with 97 consistent with metastases and 1 lesion consistent with a cyst. T1 weighted images with MnDPDP significantly detected two additional lesions compared to CT (p<0.05). No significant difference was demonstrated between T1 weighted images without MnDPDP and CT or between T2 weighted images and CT.
Magnetic resonance imaging with MnDPDP is significantly more sensitive than unenhanced MRI and helical CT for the follow-up of liver lesions.
比较在接受化疗的结直肠癌患者肝转移灶随访中,使用锰福地匹三钠(MnDPDP)的肝脏磁共振成像(MRI)与静脉注射造影剂的计算机断层扫描(CT)。
这是一项针对结直肠癌肝转移化疗患者的前瞻性研究。患者在两周内分别接受了两种检查,一种是使用2 cc/kg造影剂、以3 cc/秒的速度进行的对比增强螺旋CT,另一种是在1.5 T磁场下、使用2 - 3 cc/分钟造影剂、剂量为5微摩尔/千克的锰福地匹三钠增强磁共振成像。两位经验丰富的放射科医生以盲法独立审查所有扫描图像,并记录图像质量以及肝脏病变的存在情况和数量。使用威尔科克森符号秩检验进行统计分析。
所有检查质量良好。CT共检测到71个病灶,其中69个病灶符合转移瘤,2个病灶符合囊肿。MRI共检测到98个病灶,其中97个符合转移瘤,1个病灶符合囊肿。与CT相比,使用MnDPDP的T1加权图像显著多检测到两个病灶(p<0.05)。未使用MnDPDP的T1加权图像与CT之间、T2加权图像与CT之间均未显示出显著差异。
对于肝脏病变的随访,使用MnDPDP的磁共振成像比未增强的MRI和螺旋CT显著更敏感。