扩散加权成像及肝胆特异性对比剂钆塞酸二钠在肝脏局灶性病变诊断及鉴别诊断中的应用
[Application of Diffusion-Weighted Imaging and Hepatobiliary-Specific Contrast Agent Gd-EOB-DTPA in the Diagnosis and Differential Diagnosis of Focal Liver Lesions].
作者信息
Chen Guo-Yong, Li Zhen-Lin
机构信息
Department of Radiology, West China Hospital, Sichuan University, Chengdu 610041, China.
出版信息
Sichuan Da Xue Xue Bao Yi Xue Ban. 2022 Sep;53(5):737-743. doi: 10.12182/20220960205.
There are many types of focal liver lesions (FLL) presenting different lesion signs and their diagnosis and differential diagnosis are relatively difficult. It is of great clinical significance to accurately detect, classify and characterize focal liver lesions as soon as possible. Diffusion-weighted imaging (DWI) provides information on liver cell density, microstructure, and microcirculation perfusion. Gadolinium-ethoxibenzyl-diethylenetriamine pentaacetic acid (Gd-EOB-DTPA) is a hepatobiliary-specific contrast agent. Gd-EOB-DTPA-enhanced MRI examination of liver provides information on the blood perfusion of lesions and specific information on the uptake function of normal liver cells. The combined application of the two can significantly improve the sensitivity and diagnostic accuracy in the detection of FLL. Herein, we reviewed the research findings on the application of DWI and Gd-EOB-DTPA in FLL diagnosis in order to provide reference for further clinical application. Most of the existing studies only made comparison and discussion of the DWI image quality of different b values and their fitted apparent diffusion coefficient (ADC) values before and after Gd-EOB-DTPA enhancement, and the reported findings are not only varied, but also inconsistent. Whether Gd-EOB-DTPA will affect DWI images is still been debated. Future research should focus on quantitative comparison, discussion and verification of the enhancement effect after injection of Gd-EOB-DTPA, as well as the changes in the ADC value corresponding to different b values before and after enhancement, in order to provide more objective and consistent research results for clinical application.
肝脏局灶性病变(FLL)类型多样,呈现出不同的病变征象,其诊断及鉴别诊断相对困难。尽早准确检测、分类及表征肝脏局灶性病变具有重要的临床意义。扩散加权成像(DWI)可提供有关肝细胞密度、微观结构及微循环灌注的信息。钆塞酸二钠(Gd-EOB-DTPA)是一种肝胆特异性对比剂。Gd-EOB-DTPA增强磁共振成像(MRI)肝脏检查可提供病变血供信息及正常肝细胞摄取功能的特异性信息。两者联合应用可显著提高FLL检测的敏感性及诊断准确性。在此,我们综述了DWI及Gd-EOB-DTPA在FLL诊断中应用的研究结果,以便为进一步的临床应用提供参考。现有的大多数研究仅对Gd-EOB-DTPA增强前后不同b值的DWI图像质量及其拟合表观扩散系数(ADC)值进行了比较和讨论,报道的结果不仅各不相同,而且相互矛盾。Gd-EOB-DTPA是否会影响DWI图像仍存在争议。未来的研究应聚焦于对注射Gd-EOB-DTPA后的增强效果进行定量比较、讨论及验证,以及增强前后不同b值对应的ADC值的变化,以便为临床应用提供更客观、一致的研究结果。