Schmitz S A, Häberle J H, Balzer T, Shamsi K, Boese-Landgraf J, Wolf K J
Department of Radiology, University Hospital Benjamin Franklin, Free University of Berlin, Germany.
Radiology. 1997 Feb;202(2):399-405. doi: 10.1148/radiology.202.2.9015065.
To evaluate the efficacy and safety of gadoxetic acid disodium, or Gd-EOB-DTPA, as a tissue-specific hepatobiliary contrast agent at computed tomography (CT) in patients with liver metastases.
Fifteen patients with known liver metastases underwent CT before and at 30, 80, and, in seven cases, 150 minutes after initiation of intravenous infusion of 0.2, 0.35, and 0.5 mmol Gd/kg gadoxetic acid disodium (five patients per dose group). Attenuation in liver tissue and metastases was measured at each time point. Visualization of metastases, bile ducts, and gallbladder was graded subjectively by two investigators aware of the dose administered and the imaging time point. Patients were monitored for adverse events clinically, and numerous laboratory tests were performed over the 24 hours after administration of the contrast material.
The net mean increase in liver attenuation with 0.2, 0.35, and 0.5 mmol Gd/kg was 13 HU +/- 4 (standard deviation), 27 HU +/- 6, and 34 HU +/- 8, respectively. Visualization of liver metastases with doses of 0.35 and 0.5 mmol Gd/kg was graded as good or excellent. Visualization of the gallbladder and common bile duct with doses of 0.35 and 0.5 mmol Gd/kg was improved from minimal to excellent in 89% and 57% of patients, respectively, on 80-minute postcontrast scans. No serious adverse events occurred. Four of 15 patients experienced mild or moderate adverse events possibly or probably related to the contrast medium. Levels of aspartate and alanine aminotransferase increased in three patients by 12-26 and 21-48 U/L, respectively, from normal or moderately elevated baseline levels. These changes may be related to the contrast medium or to the metastases.
Patient tolerance of gadoxetic acid disodium was acceptable, and liver enhancement and visualization of liver lesions and the biliary system was improved at CT.
评估钆塞酸二钠（Gd-EOB-DTPA）作为一种组织特异性肝胆对比剂在肝脏转移瘤患者计算机断层扫描（CT）中的有效性和安全性。
15例已知肝脏转移瘤患者在静脉输注0.2、0.35和0.5 mmol钆/千克钆塞酸二钠（每组5例患者）前及输注后30、80分钟（7例患者在150分钟）进行CT检查。在每个时间点测量肝脏组织和转移瘤的衰减值。由两名知晓给药剂量和成像时间点的研究者对转移瘤、胆管和胆囊的显影情况进行主观分级。对患者进行临床不良事件监测，并在注射对比剂后的24小时内进行多项实验室检查。
0.2、0.35和0.5 mmol钆/千克时肝脏衰减的净平均增加分别为13 HU±4（标准差）、27 HU±6和34 HU±8。0.35和0.5 mmol钆/千克剂量时肝脏转移瘤的显影分级为良好或优秀。在注射对比剂后80分钟的扫描中，0.35和0.5 mmol钆/千克剂量时胆囊和胆总管的显影情况分别在89%和57%的患者中从轻微改善为优秀。未发生严重不良事件。15例患者中有4例出现可能或很可能与对比剂相关的轻度或中度不良事件。3例患者的天冬氨酸转氨酶和丙氨酸转氨酶水平分别从正常或中度升高的基线水平升高了12 - 26和21 - 48 U/L。这些变化可能与对比剂或转移瘤有关。
钆塞酸二钠的患者耐受性良好，CT检查时肝脏强化及肝脏病变和胆道系统的显影得到改善。
