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钆塞酸二钠(普美显®)肝胆转运时间用于优化胆道系统综合磁共振成像方案——何为正常?

Hepatobiliary transit times of gadoxetate disodium (Primovist®) for protocol optimization of comprehensive MR imaging of the biliary system--what is normal?

机构信息

Duke University Medical Center, Department of Radiology, Box 3808, Durham, NC 27710, United States.

出版信息

Eur J Radiol. 2011 Aug;79(2):201-5. doi: 10.1016/j.ejrad.2010.03.008. Epub 2010 Mar 29.

Abstract

OBJECTIVE

The purpose of this study was to determine transit times for excretion of Gd-EOB-DTPA into different segments of the hepatobiliary system in patients with normal liver function.

METHODS

This retrospective study was IRB approved with a waiver of consent granted. 61 patients (39 female, 22 male, mean age 52.5 years) with normal liver and renal function who underwent contrast enhanced hepatic MRI after injection of 10 mL Gd-EOB-DTPA at 1.5T and 3T were included. Two readers evaluated all delayed images (3-20 min post contrast) for the presence of contrast agent in the intrahepatic bile ducts (IBD), the common bile duct (CBD), the gallbladder and the duodenum. A two-tailed, unpaired Student's t-test with p<0.05 deemed significant was used to determine whether transit times were affected by patient gender, age or body mass index.

RESULTS

20 min after contrast initiation, Gd-EOB-DTPA could be detected in the IBD and the CBD in all patients (100%); gallbladder reflux was visible in 53 (86.9%), duodenal excretion in 40 patients (65.5%), respectively. Mean transit times for contrast appearance in the various segments were as follows: IBD 12 min 13s; CBD 12 min 27 s; gallbladder 13 min 32s. Transit times were not significantly affected by patient gender, age or BMI.

CONCLUSION

Within 20 min post contrast initiation, Gd-EOB-DTPA can be expected in the IBD and the CBD in patients with normal liver function. However, functional information about the sphincter Oddi complex can be ascertained only in about two thirds of these patients within this timeframe.

摘要

目的

本研究旨在确定肝功能正常患者 Gd-EOB-DTPA 排泄到肝胆系统不同节段的转运时间。

方法

本回顾性研究获得了机构审查委员会的批准,并豁免了同意书的要求。共纳入 61 例(39 例女性,22 例男性,平均年龄 52.5 岁)肝功能和肾功能正常的患者,在 1.5T 和 3T 磁共振扫描仪上静脉注射 10mL Gd-EOB-DTPA 后行增强肝脏 MRI 检查。两位读者评估所有延迟图像(对比后 3-20 分钟),以确定肝内胆管(IBD)、胆总管(CBD)、胆囊和十二指肠内是否存在对比剂。采用双侧、非配对学生 t 检验(p<0.05 认为差异有统计学意义),以确定转运时间是否受患者性别、年龄或体重指数的影响。

结果

对比剂注射后 20 分钟,所有患者(100%)的 IBD 和 CBD 均可检测到 Gd-EOB-DTPA;53 例(86.9%)可见胆囊反流,40 例(65.5%)可见十二指肠排泄。各节段对比剂出现的平均转运时间如下:IBD 12 分 13 秒;CBD 12 分 27 秒;胆囊 13 分 32 秒。转运时间不受患者性别、年龄或 BMI 的影响。

结论

在对比剂注射后 20 分钟内,预计肝功能正常的患者 IBD 和 CBD 内可出现 Gd-EOB-DTPA。然而,在此时间范围内,只有大约三分之二的患者可以获得 Oddi 括约肌复合体的功能信息。

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