Chanyaputhipong Jendana, Low Su-Chong Albert, Chow Pierce K H
Department of General Surgery, Singapore General Hospital, 169608, Singapore.
Int J Hepatol. 2011;2011:489342. doi: 10.4061/2011/489342. Epub 2011 Jul 13.
Hepatocellular carcinoma (HCC) is increasingly being detected at an earlier stage, owing to the screening programs and regular imaging follow-up in high-risk populations. Small HCCs still pose diagnostic challenges on imaging due to decreased sensitivity and increased frequency of atypical features. Differentiating early HCC from premalignant or benign nodules is important as management differs and has implications on both the quality of life and the overall survival for the patients. Gadoxetate acid (Gd-EOB-DTPA, Primovist(®), Bayer Schering Pharma) is a relatively new, safe and well-tolerated liver-specific contrast agent for magnetic resonance (MR) imaging of the liver that has combined perfusion- and hepatocyte-specific properties, allowing for the acquisition of both dynamic and hepatobiliary phase images. Its high biliary uptake and excretion improves lesion detection and characterization by increasing liver-to-lesion conspicuity in the added hepatobiliary phase imaging. To date, gadoxetate acid-enhanced MRI has been mostly shown to be superior to unenhanced MRI, computed tomography, and other types of contrast agents in the detection and characterization of liver lesions. This review article focuses on the evolving role of gadoxetate acid in the characterization of HCC, differentiating it from other mimickers of HCC.
由于高危人群的筛查计划和定期影像随访，肝细胞癌（HCC）越来越多地在早期被发现。由于敏感性降低和非典型特征频率增加，小肝癌在影像学上仍面临诊断挑战。区分早期肝癌与癌前或良性结节很重要，因为治疗方法不同，且对患者的生活质量和总体生存率都有影响。钆塞酸二钠（Gd-EOB-DTPA，普美显（®），拜耳先灵医药公司）是一种相对较新的、安全且耐受性良好的肝脏特异性磁共振（MR）成像造影剂，具有灌注和肝细胞特异性特性，可同时采集动态和肝胆期图像。其高胆汁摄取和排泄通过在附加的肝胆期成像中增加肝脏与病变的对比度，改善了病变的检测和特征描述。迄今为止，钆塞酸二钠增强MRI在肝脏病变的检测和特征描述方面大多已显示优于未增强MRI、计算机断层扫描和其他类型的造影剂。这篇综述文章重点关注钆塞酸二钠在肝癌特征描述中的不断演变的作用，将其与肝癌的其他模仿者区分开来。
