Saito Kazuhiro, Kotake Fumio, Ito Naoki, Ozuki Taizo, Mikami Ryuji, Abe Kimihiko, Shimazaki Yoko
Department of Radiology, Tokyo Medical University Kasumigaura Hospital, 3-20-1 Aminachi-chuo, Inashiki-gun, Ibaraki 300-0395, Japan.
Magn Reson Med Sci. 2005;4(1):1-9. doi: 10.2463/mrms.4.1.
The purpose of this study was to evaluate the utility of gadolinium-ethoxybenzyl-diethylenetriamine pentaacetic acid (Gd-EOB-DTPA)-enhanced magnetic resonance imaging (MRI) for the quantitative evaluation of hepatocellular carcinoma (HCC) and dysplastic nodules in the hepatobiliary phase.
The subjects comprised 12 patients with 27 lesions (22 HCCs and 5 dysplastic nodules). Chemical-shift-selective fat-suppressed T1-weighted sequences were obtained before and 10, 20, and 40 min after the injection of Gd-EOB-DTPA. Quantitative analyses were performed with the enhancement ratio of the lesion and the contrast-to-noise (C/N) ratio.
The enhancement ratios of the HCCs were 44.0+/-36.5, 44.7+/-46.8, and 47.7+/-52.8 (%) at 10, 20, and 40 min, respectively, after the injection of Gd-EOB-DTPA. The enhancement ratios of the dysplastic nodules were 36.2+/-34.3, 44.3+/-37.3, and 40.1+/-46.8 (%). The C/N ratios of the HCCs were 0.2+/-6.6 for the precontrast image, and -9.2+/-12.6, -9.9+/-14.8, and -12.7+/-15.7 at 10, 20, and 40 min, respectively, after the injection of Gd-EOB-DTPA. The C/N ratios of the dysplastic nodules were 1.4+/-8.0, -13.7+/-11.1, -13.3+/-7.6, and -13.1+/-10.4. No significant differences were found between the HCCs and the dysplastic nodules in the enhancement ratio and the C/N ratio. Only two HCCs showed a positive C/N ratio value, and these HCCs were pathologically confirmed to be a well differentiated and a moderately differentiated carcinoma, respectively.
HCCs and some of the dysplastic nodules showed hypointensity in the hepatobiliary phase in Gd-EOB-DTPA-enhanced MRI. No specific enhancement was observed, regardless of tumor differentiation.
本研究旨在评估钆塞酸二钠（Gd-EOB-DTPA）增强磁共振成像（MRI）在肝胆期对肝细胞癌（HCC）和发育异常结节进行定量评估的效用。
研究对象包括12例患者，共27个病灶（22个HCC和5个发育异常结节）。在注射Gd-EOB-DTPA前以及注射后10、20和40分钟获取化学位移选择性脂肪抑制T1加权序列。采用病灶增强率和对比噪声比（C/N）进行定量分析。
注射Gd-EOB-DTPA后10、20和40分钟，HCC的增强率分别为44.0±36.5%、44.7±46.8%和47.7±52.8%。发育异常结节的增强率分别为36.2±34.3%、44.3±37.3%和40.1±46.8%。HCC在注射前图像的C/N比为0.2±6.6，注射Gd-EOB-DTPA后10、20和40分钟分别为-9.2±12.6、-9.9±14.8和-12.7±15.7。发育异常结节的C/N比分别为1.4±8.0、-13.7±11.1、-13.3±7.6和-13.1±10.4。HCC和发育异常结节在增强率和C/N比方面未发现显著差异。仅2个HCC的C/N比值为正值，经病理证实分别为高分化和中分化癌。
在Gd-EOB-DTPA增强MRI的肝胆期，HCC和部分发育异常结节表现为低信号。无论肿瘤分化程度如何，均未观察到特异性增强。
