Department of Radiology, Kawasaki Medical School, 577 Matsushima, Kurashiki city, Okayama, 701-0192, Japan.
Eur J Radiol. 2011 Dec;80(3):e207-11. doi: 10.1016/j.ejrad.2010.08.033. Epub 2010 Sep 24.
The purpose of this study was to assess the difference in the activity of biliary and renal excretion between normal and cirrhotic livers on contrast-enhanced MR imaging obtained with gadolinium ethoxybenzyl diethylenetriaminepentaacetic acid (Gd-EOB-DTPA).
A total of 78 patients with cirrhotic liver (n=44) and with normal liver (n=34) underwent multi-phase Gd-EOB-DTPA enhanced MR imaging (arterial, portal, equilibrium, and three hepatobiliary phases (10, 15 and 20 min HP), respectively), and these contrast-enhanced images were qualitatively and quantitatively evaluated for the differences of the biliary and renal excretion between normal and cirrhotic livers.
The timing of biliary excretion of contrast agents in the cirrhotic liver was significantly slower than that in the normal liver (P<0.001). The degree of contrast enhancement in the common bile duct in the normal liver was significantly better than that in the cirrhotic liver (P=0.003). Contrast agents were demonstrated in the duodenum at 20 min HP in 8/44 (18%) cirrhotic liver while they were seen in 15/34 (44%) normal liver (P=0.013). The enhancement effects of renal medulla and portal vein at 20 min HP in the cirrhotic liver were significantly higher than those of normal liver (P=0.043 and P<0.001, respectively).
Biliary excretion of Gd-EOB-DPTA was impaired in cirrhotic livers in comparison with normal livers while renal excretion of Gd-EOB-DPTA was increased.
本研究旨在评估钆塞酸二钠(Gd-EOB-DTPA)增强磁共振成像(MRI)获得的正常和肝硬化肝脏的胆道和肾排泄活性的差异。
共 78 例肝硬化(n=44)和正常肝脏(n=34)患者进行了多期 Gd-EOB-DTPA 增强 MRI(动脉期、门脉期、平衡期和三个肝胆期(10、15 和 20 分钟 HP)),对这些对比增强图像进行定性和定量评估,以评估正常和肝硬化肝脏之间的胆道和肾排泄差异。
肝硬化肝脏对比剂的胆道排泄时间明显慢于正常肝脏(P<0.001)。正常肝脏的胆总管增强程度明显优于肝硬化肝脏(P=0.003)。在 20 分钟 HP 时,8/44(18%)例肝硬化肝脏的十二指肠中可见对比剂,而 15/34(44%)例正常肝脏中可见对比剂(P=0.013)。20 分钟 HP 时肝硬化肝脏的肾髓质和门静脉的增强效果明显高于正常肝脏(P=0.043 和 P<0.001)。
与正常肝脏相比,肝硬化肝脏的 Gd-EOB-DPTA 胆道排泄受损,而 Gd-EOB-DPTA 的肾排泄增加。