Department of Radiology, University Medical Centre Utrecht, Heidelberglaan 100, 3584CX, Utrecht, The Netherlands.
Eur Radiol. 2012 Oct;22(10):2153-60. doi: 10.1007/s00330-012-2486-2. Epub 2012 May 30.
To assess whether, in patients with normal liver function, a hepatobiliary delay time of 10 min after Gd-EOB-DTPA injection is sufficient for lesion characterisation.
In 42 consecutive patients with suspected focal liver lesions, dynamic MRI was performed after intravenous Gd-EOB-DTPA, followed by hepatobiliary phases at 5, 10 and 20 min. The following items were assessed at each hepatobiliary phase: parenchymal enhancement, contrast agent excretion in bile ducts, lesion enhancement characteristics (hypo-, iso-, or hyperintensity, rim enhancement, central non-enhancement), and contrast- and signal-to-noise ratios, separately for hypo- and hyperintense lesions.
Following enhancement, parenchymal signal intensity increased significantly up to 10 min (86.3%, P < 0.001), and subsequently stabilised (86.5% after 20 min, P = 0.223). Biliary contrast agent excretion was first observed in 2, 32 and 5 patients after 5, 10 and 20 min respectively. Hepatobiliary lesion enhancement characteristics observed after 5 min persisted during later hepatobiliary phases. CNR and SNR ratios increased significantly (P < 0.05) up to 10 min after enhancement without further increase at 20 min, in hypo- and hyperintense lesions.
If lesion characterisation is the primary reason for performing MRI, a hepatobiliary delay time of 10 min after Gd-EOB-DTPA injection is sufficient in patients with normal liver function.
• Magnetic resonance imaging is now a first line of investigation of the liver. • Optimal CNR and SNR are achieved 10 min after Gd-EOB-DTPA injection. • Typical enhancement characteristics are observed early and do not change. • Ten-minute hepatobiliary delay is sufficient for characterisation of focal liver lesions.
评估在肝功能正常的患者中,钆塞酸二钠(Gd-EOB-DTPA)注射后 10 分钟的肝胆延迟时间是否足以进行病变特征分析。
在 42 例疑似局灶性肝病变的连续患者中,静脉注射 Gd-EOB-DTPA 后进行动态 MRI 检查,随后在 5、10 和 20 分钟时进行肝胆期检查。在每个肝胆期评估以下项目:实质增强、胆管内造影剂排泄、病变增强特征(低、等、高信号,边缘增强,中央无增强),以及分别为低和高信号病变的对比和信噪比。
增强后,实质信号强度显著增加至 10 分钟(86.3%,P<0.001),随后稳定(20 分钟时为 86.5%,P=0.223)。分别在 5、10 和 20 分钟后,2、32 和 5 例患者首次观察到肝胆造影剂排泄。在 5 分钟时观察到的肝胆病变增强特征在后续肝胆期保持不变。低和高信号病变的 CNR 和 SNR 比值在增强后 10 分钟内显著增加(P<0.05),20 分钟时无进一步增加。
如果病变特征分析是进行 MRI 的主要原因,在肝功能正常的患者中,Gd-EOB-DTPA 注射后 10 分钟的肝胆延迟时间是足够的。
磁共振成像现在是肝脏的一线检查方法。
在 Gd-EOB-DTPA 注射后 10 分钟达到最佳 CNR 和 SNR。
观察到典型的增强特征较早,且不会改变。
10 分钟的肝胆延迟足以对局灶性肝病变进行特征分析。