Scali Elena P, Walshe Triona, Tiwari Hina Arif, Harris Alison C, Chang Silvia D
Department of Radiology, University of British Columbia, Vancouver, British Columbia, Canada.
Department of Radiology, University of British Columbia, Vancouver, British Columbia, Canada.
Can Assoc Radiol J. 2017 Aug;68(3):293-307. doi: 10.1016/j.carj.2016.10.008. Epub 2017 Jun 2.
Magnetic resonance imaging (MRI) has a well-established role as a highly specific and accurate modality for characterizing benign and malignant focal liver lesions. In particular, contrast-enhanced MRI using hepatocyte-specific contrast agents (HSCAs) improves lesion detection and characterization compared to other imaging modalities and MRI techniques. In this pictorial review, the mechanism of action of gadolinium-based MRI contrast agents, with a focus on HSCAs, is described. The clinical indications, protocols, and emerging uses of the 2 commercially available combined contrast agents available in the United States, gadoxetate disodium and gadobenate dimeglumine, are discussed. The MRI features of these agents are compared with examples of focal hepatic masses, many of which have been obtained within the same patient therefore allowing direct lesion comparison. Finally, the pitfalls in the use of combined contrast agents in liver MRI are highlighted.
磁共振成像(MRI)作为一种高度特异且准确的方法,在鉴别肝脏局灶性良恶性病变方面具有公认的作用。特别是,与其他成像方式和MRI技术相比,使用肝细胞特异性对比剂(HSCA)的对比增强MRI可改善病变的检测和特征描述。在本图像综述中,描述了钆基MRI对比剂的作用机制,重点是HSCA。讨论了美国市场上两种商用联合对比剂钆塞酸二钠和钆贝葡胺的临床适应证、检查方案及新用途。将这些对比剂的MRI特征与局灶性肝肿块的实例进行了比较,其中许多实例取自同一患者,因此可以直接进行病变对比。最后,强调了在肝脏MRI中使用联合对比剂时的注意事项。