Haimerl Michael, Wächtler Max, Zeman Florian, Verloh Niklas, Platzek Ivan, Schreyer Andreas Georg, Stroszczynski Christian, Wiggermann Philipp
Department of Radiology, University Medical Center Regensburg, Regensburg, Germany.
Center for Clinical Trials, University Medical Center Regensburg, Regensburg, Germany.
PLoS One. 2014 Jun 20;9(6):e100315. doi: 10.1371/journal.pone.0100315. eCollection 2014.
The objective was to investigate the dynamic enhancement patterns in focal solid liver lesions after the administration of gadolinium ethoxybenzyl diethylenetriamine pentaacetic acid (Gd-EOB-DTPA) by means of dynamic magnetic resonance imaging (MRI) including hepatobiliary phase (HP) images 20 min after Gd-EOB-DTPA administration.
Non-enhanced T1/T2-weighted as well as dynamic magnetic resonance (MR) images during the arterial phase (AP), the portal venous phase (PVP), the late phase (LP), and the HP (20 min) were obtained from 83 patients (54 male, 29 female, mean age 62.01 years) with focal solid liver lesions. MRI was conducted by means of a 1.5-T system for 63 patients with malignant liver lesions (HCCs: n = 34, metastases: n = 29) and for 20 patients with benign liver lesions (FNH lesions: n = 14, hemangiomas: n = 3, adenomas: n = 3). For quantitative analysis, signal-to-noise ratios (SNR), contrast enhancement ratios (CER), lesion-to-liver contrast ratios (LLC), and signal intensity (SI) ratios were measured.
The SNR of liver parenchyma significantly increased in each dynamic phase after Gd-EOB-DTPA administration compared to the SNR of non-enhanced images (p<0.001). The CER of HCCs and metastases significantly decreased between LP and HP images (p = 0.0011, p<0.0001). However, FNH lesions did not show any significant difference, whereas an increased CER was found in hemangiomas. The mean LLCs of FNH lesions were significantly higher than those of HCCs and metastases. The LLC values of hemangiomas remained negative during the entire time course, whereas the LLC of adenomas indicated hyperintensity from the AP to the LP. Furthermore, adenomas showed hypointensity in HP images.
Gd-EOB-DTPA-enhanced MRI may help diagnose focal solid liver lesions by evaluating their enhancement patterns.
本研究旨在通过动态磁共振成像（MRI），包括钆塞酸二钠（Gd-EOB-DTPA）给药20分钟后的肝胆期（HP）图像，研究局灶性肝脏实性病变的动态增强模式。
对83例（男54例，女29例，平均年龄62.01岁）局灶性肝脏实性病变患者进行了非增强T1/T2加权成像以及动脉期（AP）、门静脉期（PVP）、延迟期（LP）和肝胆期（20分钟）的动态磁共振（MR）成像。63例肝脏恶性病变（肝细胞癌：n = 34，转移瘤：n = 29）和20例肝脏良性病变（局灶性结节性增生病变：n = 14，血管瘤：n = 3，腺瘤：n = 3）患者采用1.5-T系统进行MRI检查。进行定量分析时，测量了信噪比（SNR）、对比增强率（CER）、病变与肝脏对比率（LLC）和信号强度（SI）比。
与非增强图像的SNR相比，Gd-EOB-DTPA给药后各动态期肝脏实质的SNR显著增加（p<0.001）。肝细胞癌和转移瘤的CER在LP和HP图像之间显著降低（p = 0.0011，p<0.0001）。然而，局灶性结节性增生病变未显示任何显著差异，而血管瘤的CER增加。局灶性结节性增生病变的平均LLC显著高于肝细胞癌和转移瘤。血管瘤的LLC值在整个时间过程中均为负值，而腺瘤的LLC在AP至LP期间呈高信号。此外，腺瘤在HP图像中呈低信号。
Gd-EOB-DTPA增强MRI可通过评估局灶性肝脏实性病变的增强模式，有助于其诊断。
