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肝硬化患者门静脉期肝实质增强:钆塞酸二钠与钆贝葡胺有何不同?

Hepatic enhancement in cirrhosis in the portal venous phase: what are the differences between gadoxetate disodium and gadobenate dimeglumine?

机构信息

Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties, University Hospital of Palermo, Via del Vespro 129, 90127, Palermo, Italy.

University Paris Diderot, Sorbonne Paris Cité, Paris, France.

出版信息

Abdom Radiol (NY). 2020 Aug;45(8):2409-2417. doi: 10.1007/s00261-020-02578-4.

Abstract

PURPOSE

To compare the level of parenchymal and portal venous enhancement in the portal venous phase (PVP) in cirrhotic patients undergoing gadoxetate disodium- and gadobenate dimeglumine-enhanced MRI.

METHODS

In this retrospective study, 84 cirrhotic patients (mean age ± SD: 66 ± 13 years) who underwent contrast-enhanced MRI with both gadoxetate disodium and gadobenate dimeglumine between 2012 and 2018 were included. Two readers measured signal intensities of hepatic parenchyma, portal vein and psoas muscle on precontrast and PVP. Relative enhancement (RE), image contrast, and portal vein-to-liver contrast difference were calculated. Intraindividual differences were compared with the Wilcoxon signed rank-sum test and inter-reader differences with the intraclass correlation coefficient (ICC).

RESULTS

In PVP, gadoxetate disodium provided lower RE than gadobenate dimeglumine (Reader 1: 42.4 ± 44.6 vs. 56.1 ± 58.8, p = 0.044; Reader 2: 42.4 ± 42.9 vs. 57.7 ± 60.5, p = 0.027;), lower image contrast (Reader 1: 0.27 ± 0.11 vs. 0.35 ± 0.11, respectively; p < 0.001; Reader 2: 0.29 ± 0.10 vs. 0.37 ± 0.07, respectively; p < 0.001), and lower portal vein-to-liver contrast difference (Reader 1: 0.89 ± 0.39 vs. 1.42 ± 0.90, p < 0.001; Reader 2: 0.95 ± 0.40 vs. 1.28 ± 0.37, p < 0.001). ICC was 0.94, 0.79, and 0.69 for RE, image contrast, and portal vein-to-liver contrast difference, respectively.

CONCLUSION

In cirrhotic patients, gadoxetate disodium yielded lower enhancement of the hepatic parenchyma and lower contrast of the portal vein than gadobenate dimeglumine in PVP.

摘要

目的

比较肝硬化患者行钆塞酸二钠和钆贝葡胺增强 MRI 检查门静脉期(PVP)时实质和门静脉强化程度。

方法

本回顾性研究纳入了 2012 年至 2018 年间行钆塞酸二钠和钆贝葡胺增强 MRI 检查的 84 例肝硬化患者(平均年龄 ± 标准差:66 ± 13 岁)。两名读者分别在平扫和 PVP 时测量肝实质、门静脉和腰大肌的信号强度。计算相对增强(RE)、图像对比度和门静脉-肝对比度差异。采用 Wilcoxon 符号秩和检验比较个体内差异,采用组内相关系数(ICC)比较读者间差异。

结果

在 PVP 时,钆塞酸二钠的 RE 低于钆贝葡胺(读者 1:42.4 ± 44.6 比 56.1 ± 58.8,p = 0.044;读者 2:42.4 ± 42.9 比 57.7 ± 60.5,p = 0.027),图像对比度更低(读者 1:0.27 ± 0.11 比 0.35 ± 0.11,p < 0.001;读者 2:0.29 ± 0.10 比 0.37 ± 0.07,p < 0.001),门静脉-肝对比度差异更小(读者 1:0.89 ± 0.39 比 1.42 ± 0.90,p < 0.001;读者 2:0.95 ± 0.40 比 1.28 ± 0.37,p < 0.001)。RE、图像对比度和门静脉-肝对比度差异的 ICC 分别为 0.94、0.79 和 0.69。

结论

在肝硬化患者中,钆塞酸二钠在 PVP 时肝实质强化程度和门静脉对比度均低于钆贝葡胺。

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