Department of Diagnostic Imaging, Rhode Island Hospital - Hasbro Children's Hospital, Warren Alpert Medical School of Brown University, 593 Eddy St., Providence, RI, 02903, USA.
Department of Radiology, The Children's Hospital of Philadelphia, Philadelphia, PA, USA.
Pediatr Radiol. 2019 Sep;49(10):1256-1268. doi: 10.1007/s00247-019-04476-4. Epub 2019 Jul 26.
Hepatocyte-specific contrast agents (HSCAs) are a group of intravenous gadolinium-based MRI contrast agents that can be used to characterize hepatobiliary pathology. The mechanism by which these agents are taken up by hepatocytes and partially excreted into the biliary tree improves characterization of hepatic lesions and biliary abnormalities relative to conventional extracellular gadolinium-based contrast agents (GBCAs). This manuscript presents an overview of HSCA use in pediatric patients with the intent to provide radiologists a guide for clinical use. We review available HSCAs and discuss dosing and age specifications for use in children. We also review various hepatic and biliary indications for HSCA use in children, with emphasis on the imaging characteristics distinct to HSCAs, as well as discussion of pitfalls one can encounter when imaging with HSCAs. Given the growing concern regarding gadolinium deposition in soft tissues and brain, we also discuss safety of HSCA use in children.
肝细胞特异性对比剂（HSCAs）是一组静脉注射的基于钆的 MRI 对比剂，可用于表征肝胆病理。这些药物被肝细胞摄取并部分排入胆道的机制改善了对肝病变和胆道异常的特征，与传统的基于细胞外的钆基对比剂（GBCAs）相比。本文概述了 HSCAs 在儿科患者中的应用，旨在为放射科医生提供临床应用指南。我们回顾了现有的 HSCAs，并讨论了在儿童中使用的剂量和年龄规范。我们还回顾了 HSCAs 在儿童中的各种肝胆适应证，重点介绍了 HSCAs 特有的成像特征，并讨论了在使用 HSCAs 成像时可能遇到的陷阱。鉴于人们对软组织和大脑中钆沉积的担忧日益增加，我们还讨论了 HSCAs 在儿童中的使用安全性。
