Petersein J, Saini S, Mitchell D G, Davis P L, Johnson C D, Kuhlman J E, Parisky Y R, Runge V M, Weinreb J, Bernardino M E
Department of Radiology, Massachusetts General Hospital, Boston 02114, USA.
AJR Am J Roentgenol. 1995 Nov;165(5):1157-61. doi: 10.2214/ajr.165.5.7572495.
The purpose of this study was to compare liver signal-to-noise ratio (SNR), lesion SNR, and lesion-liver contrast-to-noise-ratio (CNR) in patients with malignant liver lesions after the administration of a standard dose (0.1 mmol/kg of body weight) or a triple dose (0.3 mmol/kg) of a gadolinium chelate (gadoteridol). We hypothesized that the higher dose would produce a higher lesion-liver CNR and therefore increase the conspicuity of hepatic lesions.
A total of 85 patients with malignant hepatic masses (61 metastases, 22 hepatocellular carcinomas, and two lymphomas) proved by histologic or follow-up studies underwent MR imaging at 1.5 T. T1-weighted spin-echo imaging and gradient-echo imaging were done before and within 1 min after (gradient echo) as well as 5 (spin echo) and 15 (spin echo) min after the injection of 0.1 or 0.3 mmol of gadoteridol per kg, randomized before the start of the study (39 patients received the standard dose, and 46 received the triple dose). The signal intensities of the liver and lesions and the SD of background noise were measured by use of regions of interest to calculate the SNR of the liver and malignant lesions and the lesion-liver CNR.
The lesion-liver CNR was increased significantly at 5 and 15 min after the administration of gadoteridol. No significant differences in the liver SNR, lesion SNR, and lesion-liver CNR (after 1 min: standard dose, -5 +/- 8, and triple dose, -4 +/- 14; after 5 min: standard dose, -1 +/- 5, and triple dose, 2 +/- 8; and after 15 min: standard dose, 1 +/- 5, and triple dose, 6 +/- 20) were found between the doses at all time points.
Triple-dose gadoteridol does not improve the lesion-liver contrast of malignant hepatic lesions over that provided by the standard dose and is not warranted for liver MR imaging.
本研究旨在比较给予标准剂量（0.1 mmol/kg体重）或三倍剂量（0.3 mmol/kg）钆螯合物（钆特醇）后，恶性肝病变患者肝脏的信噪比（SNR）、病变SNR以及病变-肝脏对比噪声比（CNR）。我们假设较高剂量会产生更高的病变-肝脏CNR，从而提高肝脏病变的可视性。
85例经组织学或随访研究证实患有恶性肝肿块（61例转移瘤、22例肝细胞癌和2例淋巴瘤）的患者在1.5 T下行磁共振成像。在注射每千克0.1或0.3 mmol钆特醇之前、之后1分钟内（梯度回波）以及之后5分钟（自旋回波）和15分钟（自旋回波）进行T1加权自旋回波成像和梯度回波成像，在研究开始前随机分组（39例患者接受标准剂量，46例接受三倍剂量）。利用感兴趣区测量肝脏和病变的信号强度以及背景噪声的标准差，以计算肝脏和恶性病变的SNR以及病变-肝脏CNR。
给予钆特醇后5分钟和15分钟，病变-肝脏CNR显著增加。在所有时间点，不同剂量之间在肝脏SNR、病变SNR以及病变-肝脏CNR方面均未发现显著差异（1分钟后：标准剂量为-5±8，三倍剂量为-4±14；5分钟后：标准剂量为-1±5，三倍剂量为2±8；15分钟后：标准剂量为1±5，三倍剂量为6±20）。
三倍剂量的钆特醇在改善恶性肝病变的病变-肝脏对比方面并不优于标准剂量，因此在肝脏磁共振成像中并无必要使用。
