1 Department of Radiology, Body MRI, Translational and Molecular Imaging Institute, Mount Sinai School of Medicine, One Gustave Levy Pl, Box 1234, New York, NY 10029.
AJR Am J Roentgenol. 2013 Oct;201(4):795-800. doi: 10.2214/AJR.12.9798.
The objective of our study was to report our initial experience with dynamic contrast-enhanced MRI (DCE-MRI) for perfusion quantification of hepatocellular carcinoma (HCC) and surrounding liver.
DCE-MRI of the liver was prospectively performed on 31 patients with HCC (male-female ratio, 26:5; mean age, 61 years; age range, 41-83 years). A dynamic coronal 3D FLASH sequence was performed at 1.5 T before and after injection of gadolinium-based contrast agent with an average temporal resolution of 3.8 seconds. Regions of interest were drawn on the abdominal aorta, portal vein, liver parenchyma, and HCC lesions by two observers in consensus. Time-activity curves were analyzed using a dual-input single-compartment model. The following perfusion parameters were obtained: arterial flow, portal venous flow, arterial fraction, distribution volume, and mean transit time (MTT).
Thirty-three HCCs (mean size, 3.9 cm; range, 1.1-12.6 cm) were evaluated in 26 patients. When compared with liver parenchyma, HCC showed significantly higher arterial hepatic blood flow and arterial fraction (p < 0.0001) and significantly lower distribution volume and portal venous hepatic blood flow (p < 0.0001-0.023), with no difference in MTT. Untreated HCCs (n = 16) had a higher arterial fraction and lower portal venous hepatic blood flow value than chemoembolized HCCs (n = 17, p < 0.04).
DCE-MRI can be used to quantify perfusion metrics of HCC and liver parenchyma and to assess perfusion changes after HCC chemoembolization.
本研究旨在报告我们在使用动态对比增强磁共振成像（DCE-MRI）对肝细胞癌（HCC）及其周围肝脏进行灌注量化方面的初步经验。
前瞻性地对 31 例 HCC 患者（男/女，26/5；平均年龄 61 岁；年龄范围 41-83 岁）进行肝脏 DCE-MRI 检查。在 1.5 T 上使用动态冠状 3D FLASH 序列在注射钆基造影剂前后进行检查，平均时间分辨率为 3.8 秒。两名观察者在共识的基础上在腹主动脉、门静脉、肝实质和 HCC 病变上画出感兴趣区。使用双输入单室模型分析时间-活性曲线。获得以下灌注参数：动脉血流量、门静脉血流量、动脉分数、分布容积和平均通过时间（MTT）。
在 26 例患者中评估了 33 个 HCC（平均大小为 3.9 cm；范围 1.1-12.6 cm）。与肝实质相比，HCC 显示出明显更高的动脉肝血流量和动脉分数（p < 0.0001），以及明显更低的分布容积和门静脉肝血流量（p < 0.0001-0.023），MTT 无差异。未治疗的 HCC（n = 16）的动脉分数和门静脉肝血流量值高于化疗栓塞的 HCC（n = 17，p < 0.04）。
DCE-MRI 可用于量化 HCC 和肝实质的灌注指标，并评估 HCC 化疗栓塞后的灌注变化。
