Saito Kazuhiro, Hashimoto Tsuyoshi, Kotake Fumio, Nakamura Hiroshi, Mizokami Yuji, Shimokobe Koichi, Abe Kimihiko
Department of Radiology, Tokyo Medical University Kasumigaura Hospital, 3-20-1 Amimachi-chuo, Inashiki-gun, Ibaraki 300-0332, Japan.
Magn Reson Med Sci. 2002 Dec 15;1(4):199-205. doi: 10.2463/mrms.1.199.
A study was conducted to determine the possibility of evaluating the blood flow in cases of hypervascular hepatocellular carcinoma (HCC) by employing dynamic MRI with superparamagnetic iron oxide (SH U 555 A), which can be rapidly injected via an intravenous route.
Six patients with hypervascular HCC (23 nodules) served as the subjects. Dynamic MRI includes images obtained at precontrast and at 10 (perfusion phase), 60, 120, 180, 240, 300 and 600 s after the start of injection of SH U 555 A. CT hepatic arteriography (CTHA) and CT during arterial portography (CTAP) were used as the standards of reference, and these were performed in all patients three days after dynamic MRI. The signal changes were evaluated at each phase, especially at the perfusion phase from the viewpoints of a lesion-to-liver contrast-to-noise ratio (CNR) and visual examination.
A total of 23 hypervascular HCC were detected on CTHA and CTAP. Of the 23 lesions, 17 were detected on SH U 555 A enhanced MRI. Incorrect timing during acquisition of the perfusion phase was considered in two cases with three lesions. Of 14 lesions, excluding two cases with incorrect timing, a reduction in the transient signal in the lesions at the perfusion phase was visually recognized in 10 lesions (71%). Significant differences were seen in tumor size between visible and non-visible tumors involving transient signal reduction (p< 0.05). CNR gradually increased after rapidly decreasing in the perfusion phase.
SH U 555 A enhanced MRI is valuable in limited cases. Evaluation of tumor blood flow employing dynamic MRI with SH U 555 A is affected by tumor size and requires optimal timing of the perfusion phase.
开展一项研究，以确定通过使用可经静脉快速注射的超顺磁性氧化铁（SH U 555 A）进行动态磁共振成像（MRI）来评估高血供肝细胞癌（HCC）血流情况的可能性。
6例高血供HCC患者（共23个结节）作为研究对象。动态MRI包括在注射SH U 555 A前以及注射开始后10秒（灌注期）、60秒、120秒、180秒、240秒、300秒和600秒时获取的图像。将CT肝动脉造影（CTHA）和动脉门静脉造影CT（CTAP）用作参考标准，且在动态MRI检查三天后对所有患者进行这两项检查。在每个阶段评估信号变化，尤其是在灌注期，从病变与肝脏的对比噪声比（CNR）和视觉检查的角度进行评估。
CTHA和CTAP共检测到23个高血供HCC病变。在这23个病变中，17个在SH U 555 A增强MRI上被检测到。在两个包含三个病变的病例中，考虑存在灌注期采集时的时间错误。在排除两个时间错误病例后的14个病变中，在灌注期有10个病变（71%）在视觉上可识别出病变内短暂信号降低。在涉及短暂信号降低的可见和不可见肿瘤之间，肿瘤大小存在显著差异（p<0.05）。CNR在灌注期迅速下降后逐渐升高。
SH U 555 A增强MRI在有限的病例中具有价值。使用SH U 555 A进行动态MRI评估肿瘤血流受肿瘤大小影响，并且需要灌注期的最佳时间。
