Motosugi Utaroh, Ichikawa Tomoaki, Sou Hironobu, Sano Katsuhiro, Ichikawa Shintaro, Tominaga Licht, Araki Tsutomu
Department of Radiology, University of Yamanashi, Japan.
J Magn Reson Imaging. 2009 Oct;30(4):849-54. doi: 10.1002/jmri.21913.
To elucidate whether a contrast agent dilution method (dilution method), in which gadoxetate disodium (Gd-EOB-DTPA) is diluted with saline, is useful for good-quality arterial-phase images.
In this study we observed 494 hypervascular hepatocellular carcinomas (HCCs) in 327 patients with chronic liver disease. Three Gd-EOB-DTPA injection methods were adopted for comparison: 1) test injection method (undiluted Gd-EOB-DTPA and modified scan delay), in which a test dose of 0.5 mL of Gd-EOB-DTPA was injected to determine scan delay; 2) conventional method (undiluted Gd-EOB-DTPA and fixed scan delay); and (3) dilution method (diluted Gd-EOB-DTPA and fixed scan delay), in which Gd-EOB-DTPA was diluted to 20 mL with saline. Lesion-liver contrast was calculated. Image quality and lesion detectability were evaluated by two radiologists blinded to the injection methods.
The lesion-liver contrast of the dilution method was significantly higher than that of the other two methods. Lesion detectability of the conventional method (64%) was significantly lower than that of the other two methods (contrast agent dilution method, 95%; test injection method, 93%). The image quality of the contrast agent dilution method was significantly better than that of the other two methods.
The dilution method contributed to improved image quality, high lesion-liver contrast, and high lesion detectability in the arterial-phase images of GD-EOB-DTPA-enhanced MRI.
阐明一种用生理盐水稀释钆塞酸二钠(Gd-EOB-DTPA)的造影剂稀释方法(稀释法)是否有助于获得高质量的动脉期图像。
本研究观察了327例慢性肝病患者的494个富血供肝细胞癌(HCC)。采用三种Gd-EOB-DTPA注射方法进行比较:1)试验注射法(未稀释的Gd-EOB-DTPA和改良扫描延迟),即注射0.5 mL的Gd-EOB-DTPA试验剂量以确定扫描延迟;2)传统方法(未稀释的Gd-EOB-DTPA和固定扫描延迟);以及(3)稀释法(稀释的Gd-EOB-DTPA和固定扫描延迟),即将Gd-EOB-DTPA用生理盐水稀释至20 mL。计算病变与肝脏的对比度。由两位对注射方法不知情的放射科医生评估图像质量和病变可检测性。
稀释法的病变与肝脏对比度显著高于其他两种方法。传统方法的病变可检测性(64%)显著低于其他两种方法(造影剂稀释法,95%;试验注射法,93%)。造影剂稀释法的图像质量显著优于其他两种方法。
在Gd-EOB-DTPA增强MRI的动脉期图像中,稀释法有助于提高图像质量、病变与肝脏的对比度以及病变可检测性。