肝脏局灶性病变的磁共振成像。同一患者中超顺磁性氧化铁对比剂Resovist与钆-DTPA的比较。

Magnetic resonance imaging of focal liver lesions. Comparison of the superparamagnetic iron oxide resovist versus gadolinium-DTPA in the same patient.

作者信息

Vogl T J, Hammerstingl R, Schwarz W, Kümmel S, Müller P K, Balzer T, Lauten M J, Balzer J O, Mack M G, Schimpfky C, Schrem H, Bechstein W O, Neuhaus P, Felix R

机构信息

Department of Radiology, Humboldt University of Berlin, Rudolf Virchow Hospital, Germany.

出版信息

Invest Radiol. 1996 Nov;31(11):696-708. doi: 10.1097/00004424-199611000-00004.

DOI:10.1097/00004424-199611000-00004

PMID:8915751

Abstract

RATIONALE AND OBJECTIVES

The authors assess the efficacy of static and dynamic magnetic resonance (MR) imaging using the superparamagnetic iron oxide SHU-555A (Resovist) versus standard dose of gadolinium (Gd)-DTPA in patients with focal liver lesions.

METHODS

Magnetic resonance imaging was performed in 30 patients suffering from histopathologically verified malignant (n = 22) and benign (n = 8) liver lesions. T2-weighted conventional and fat-suppressed as well as T1-weighted sequences were used before, during, and after fast intravenous administration of Resovist (1 mL/minute) at three doses of 4, 8, and 16 mumol/kg body weight. One week before the Resovist-enhanced MR imaging study 20 patients underwent Gd-DTPA-enhanced MR imaging.

RESULTS

Detection rate was improved for metastatic lesions revealing 36 lesions unenhanced versus 53 focal lesions using Resovist-enhanced MR imaging. Gadolinium-DTPA-enhanced scans showed no additional lesion versus unenhanced and Resovist-enhanced MR imaging. Static and dynamic imaging demonstrated no measurable percentage signal intensity loss (PSIL) using Resovist-enhanced MR imaging versus a percentage enhancement of 79.7% in Gd-DTPA enhanced scans. In the dynamic T2-weighted sequences, hepatocellular carcinoma nodules (n = 4) showed a rapid decrease in signal intensity starting at 44 seconds. Postinfusion of Resovist followed by a low, constant increase in signal intensity. Gadolinium-DTPA enhanced scans showed a percentage enhancement of 73.4 focal nodular hyperplasia (FNH) and hemangioma revealed a strong and early dose-dependent PSIL 44 to 60 seconds postinfusion with a prolonged signal loss for the FNH in the late study. Statistical evaluation revealed a statistically significant superiority of Resovist-enhanced MR imaging concerning the detection and delineation of focal liver lesions compared with unenhanced and Gd-DTPA enhanced scans (P < 0.05).

CONCLUSIONS

The fast infusion of the new superparamagnetic contrast agent Resovist shows advantages for dynamic and static MR imaging of focal liver lesions.

摘要

原理与目的

作者评估超顺磁性氧化铁SHU - 555A（Resovist）与标准剂量钆（Gd）- DTPA在肝脏局灶性病变患者中进行静态和动态磁共振（MR）成像的疗效。

方法

对30例经组织病理学证实患有恶性（n = 22）和良性（n = 8）肝脏病变的患者进行磁共振成像。在以4、8和16 μmol/kg体重三种剂量快速静脉注射Resovist（1毫升/分钟）之前、期间和之后，使用T2加权常规和脂肪抑制序列以及T1加权序列。在Resovist增强磁共振成像研究前一周，20例患者接受了Gd - DTPA增强磁共振成像。

结果

使用Resovist增强磁共振成像时，转移性病变的检出率有所提高，显示36个未增强病变与53个局灶性病变。Gd - DTPA增强扫描与未增强及Resovist增强磁共振成像相比未显示出额外病变。使用Resovist增强磁共振成像时，静态和动态成像未显示出可测量的信号强度损失百分比（PSIL），而Gd - DTPA增强扫描的增强百分比为79.7%。在动态T2加权序列中，肝细胞癌结节（n = 4）在44秒时开始信号强度迅速下降。注射Resovist后信号强度随后缓慢、持续增加。Gd - DTPA增强扫描显示局灶性结节性增生（FNH）的增强百分比为73.4%，血管瘤在注射后44至60秒显示出强烈且早期的剂量依赖性PSIL，在后期研究中FNH的信号损失持续时间延长。统计评估显示，与未增强及Gd - DTPA增强扫描相比，Resovist增强磁共振成像在肝脏局灶性病变的检测和勾勒方面具有统计学上的显著优势（P < 0.05）。