Department of Radiology, Gifu University, 1-1 Yanagido, Gifu, 501-1194, Japan.
Department of Diagnostic Radiology & Nuclear Medicine, Hamamatsu University, Hamamatsu, Japan.
Abdom Radiol (NY). 2020 Aug;45(8):2459-2468. doi: 10.1007/s00261-020-02511-9.
To compare the detectability of pancreatic ductal adenocarcinoma (PDAC) and liver metastases between Gd-EOB-DTPA- and extracellular contrast materials (ECCMs) contrast-enhanced MR imaging contrast.
Two hundred seventy-two patients with suspected pancreatic disease underwent Gd-EOB-DTPA-enhanced MR imaging (EOB group, n = 79) or ECCMs-enhanced MR imaging (ECCM group, n = 193). The ECCM group were administered the following contrast agents: Gd-DTPA (n = 158), Gd-BT-DO3A (n = 28), Gd-DOTA (n = 5), and Gd-DTPA-BMA (n = 2). Signal intensities of pancreatic parenchyma, paraspinal muscle, PDAC (if present), and background noise were measured. The signal intensity ratio (SIR) of the pancreas and tumor-to-pancreas contrast-to-noise ratio (CNR) were also calculated. If present, the conspicuity of PDAC was evaluated with the arterial dominant phase images. Liver metastases, if present, were also evaluated for all sequences. Qualitative and quantitative imaging parameters were compared between EOB and ECCM groups.
SIR of the pancreas (P < 0.001) and CNR (P = 0.0037) were significantly lower in EOB group when compared with the ECCM group. However, the sensitivity (97.1% vs. 93.5%, P = 0.42) and specificity (100.0% vs. 99.2%, P = 1.00) for detecting PDAC were not significant between EOB and ECCM groups. The EOB group showed a significantly greater sensitivity for detecting liver metastases compared with the ECCM group (95.0% vs 84.5%, P = 0.04) when evaluating on a lesion-by-lesion basis.
Gd-EOB-DTPA-enhanced MR imaging performed similarly to ECCMs-enhanced MR imaging in detecting PDAC but had better sensitivity in detecting liver metastases.
比较钆塞酸二钠（Gd-EOB-DTPA）与细胞外对比剂（ECCMs）对比增强磁共振成像对比在胰腺导管腺癌（PDAC）和肝转移检测中的可探测性。
272 名疑似胰腺疾病患者接受 Gd-EOB-DTPA 增强磁共振成像（EOB 组，n=79）或 ECCMs 增强磁共振成像（ECCM 组，n=193）。ECCM 组给予以下造影剂：Gd-DTPA（n=158）、Gd-BT-DO3A（n=28）、Gd-DOTA（n=5）和 Gd-DTPA-BMA（n=2）。测量胰腺实质、椎旁肌肉、PDAC（如有）和背景噪声的信号强度。还计算了胰腺和肿瘤的信号强度比（SIR）和肿瘤-胰腺对比噪声比（CNR）。如果存在 PDAC，则评估动脉优势期图像的 PDAC 显影程度。如果存在肝转移，也对所有序列进行评估。比较 EOB 和 ECCM 组之间的定性和定量成像参数。
与 ECCM 组相比，EOB 组的胰腺 SIR（P<0.001）和 CNR（P=0.0037）显著降低。然而，EOB 组和 ECCM 组检测 PDAC 的灵敏度（97.1%比 93.5%，P=0.42）和特异性（100.0%比 99.2%，P=1.00）没有显著差异。在基于病变的评估中，EOB 组检测肝转移的灵敏度显著高于 ECCM 组（95.0%比 84.5%，P=0.04）。
Gd-EOB-DTPA 增强磁共振成像在检测 PDAC 方面与 ECCMs 增强磁共振成像相似，但在检测肝转移方面具有更高的灵敏度。
