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钆塞酸二钠增强磁共振成像在我国肝脏局灶性病变中的应用:一项多中心、开放标签、III 期研究。

Gd-EOB-DTPA-enhanced magnetic resonance imaging for focal liver lesions in Chinese patients: a multicenter, open-label, phase III study.

机构信息

Department of Radiology, Zhongshan Hospital, Fudan University, Shanghai 200032, China.

出版信息

Hepatobiliary Pancreat Dis Int. 2013 Dec;12(6):607-16. doi: 10.1016/s1499-3872(13)60096-x.

DOI:10.1016/s1499-3872(13)60096-x
PMID:24322746
Abstract

BACKGROUND

Contrast agents help to improve visibility in magnetic resonance (MR) imaging. However, owing to the large interstitial spaces of the liver, there is a reduction in the natural contrast gradient between lesions and healthy tissue. This study was undertaken to evaluate the efficacy and safety of the liver-specific MR imaging contrast agent gadoxetate disodium (Gd-EOB-DTPA) in Chinese patients.

METHODS

This was a single-arm, open-label, multicenter study in patients with known or suspected focal liver lesions referred for contrast-enhanced MR imaging. MR imaging was performed in 234 patients before and after a single intravenous bolus of Gd-EOB-DTPA (0.025 mmol/kg body weight). Images were evaluated by clinical study investigators and three independent, blinded radiologists. The primary efficacy endpoint was sensitivity in lesion detection.

RESULTS

Gd-EOB-DTPA improved sensitivity in lesion detection by 9.46% compared with pre-contrast imaging for the average of the three blinded readers (94.78% vs 85.32% for Gd-EOB-DTPA vs pre-contrast, respectively). Improvements in detection were more pronounced in lesions less than 1 cm. Gd-EOB-DTPA improved diagnostic accuracy in lesion classification.

CONCLUSIONS

This open-label study demonstrated that Gd-EOB-DTPA improves diagnostic sensitivity in liver lesions, particularly in those smaller than 1 cm. Gd-EOB-DTPA also significantly improves the diagnostic accuracy in lesion classification, and furthermore, Gd-EOB-DTPA is safe in Chinese patients with liver lesions.

摘要

背景

对比剂有助于提高磁共振成像(MR)的可视性。然而,由于肝脏的间质空间较大,病变与健康组织之间的自然对比梯度降低。本研究旨在评估钆塞酸二钠(Gd-EOB-DTPA)作为一种肝脏特异性磁共振成像对比剂在中国人中的疗效和安全性。

方法

这是一项在中国已知或疑似局灶性肝脏病变患者中进行的单臂、开放标签、多中心研究,这些患者需要进行对比增强磁共振成像检查。在 Gd-EOB-DTPA(0.025mmol/kg 体重)单次静脉推注前后,对 234 例患者进行了磁共振成像检查。临床研究研究者和三位独立的、盲法的放射科医生对图像进行了评估。主要疗效终点是病变检测的灵敏度。

结果

与增强前成像相比,Gd-EOB-DTPA 平均提高了三位盲法读者的病变检测灵敏度 9.46%(Gd-EOB-DTPA 为 94.78%,增强前为 85.32%)。对于小于 1cm 的病变,检测改善更为明显。Gd-EOB-DTPA 提高了病变分类的诊断准确性。

结论

这项开放标签研究表明,Gd-EOB-DTPA 提高了肝脏病变的诊断灵敏度,特别是对于小于 1cm 的病变。Gd-EOB-DTPA 还显著提高了病变分类的诊断准确性,此外,Gd-EOB-DTPA 在患有肝脏病变的中国患者中是安全的。

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