Gd-BOPTA增强MRI对小肝癌的诊断价值

目的　比较Gd BOPTA增强MRI与MRI平扫、Gd DTPA动态增强MRI在诊断小肝癌 (SHCC)方面的差异 ,进一步提高小肝癌检出率和诊断准确性并观察其不良反应。资料与方法　手术或穿刺病理证实为SHCC患者 2 5例。采用GESigna 1.5T磁共振扫描仪。行SE序列T1WI、FSE序列T2 WI及Gd DTPA快速动态增强多期扫描。Gd BOPTA增强扫描亦采用静脉团注快速动态增强扫描 (同Gd DTPA) ,并在团注后 15min、6 0min行SE序列T1WI和FMPSPGR序列T1WI扫描各 1次。观察MRI平扫、Gd DTPA快速动态增强和Gd BOPTA增强扫描及延迟扫描对病灶的检出率、包膜显示情况以及病灶的强化特征并行统计学分析。观察其不良反应。结果　 2 5例患者共发现病灶4 2个。对SHCC病灶的检出率 ,MRI平扫为 6 9.0 5 % ,Gd DTPA增强为 85 .71% ,Gd BOPTA增强 (动态 延迟 )为95 .2 4 % ,和Gd DTPA增强之间无统计学差异 ,和MRI平扫有统计学意义。病理检查发现 30个病灶有包膜。Gd BOPTA增强对SHCC包膜的显示 ...

Evaluation of Gd-BOPTA Enhanced MRI in the Diagnosis of Small HCC

Objective To compare gadobenate dimeglumine (Gd-BOPTA) enhanced MRI, plain MRI and Gd-DTPA dynamic MRI in diagnosing small hepatocellular carcinoma (SHCC), to further improve the detecting rate and diagnostic accuracy of SHCC. Materials and Methods Twenty-five patients with pathologically proved SHCC underwent MR examination with a 1.5T Signa scanner. The exam included SE T 1WI, FSE T 2WI, Gd-DTPA dynamic enhanced MRI and Gd-BOPTA dynamic enhanced MRI. DCE MRI scanning started when the intravenous infusion of Gd-BOPTA was finished. Then, SE T 1WI and FMPSPGR T 1WI scans were followed at 15min and 60min delay using the same sequences. The detection, capsule and enhanced pattern of SHCC lesions on different scans were observed, and the results were statistically analyzed. Results In 25 patients with SHCC, a total 42 lesions were found. The detection rate of plain MRI, Gd-DTPA dynamic enhanced MRI and Gd-BOPTA enhanced MRI was 69.05%, 85.71% and 95.24%, respectively. No significant difference was found between Gd-BOPTA enhanced MRI and Gd-DTPA dynamic enhanced MRI, but significant difference existed between Gd-BOPTA enhanced MRI and plain MRI. Pathologically, capsule was found in 30 lesions. The detection rate of SHCC capsule by Gd-BOPTA enhanced MRI was 86.67%, which was significantly higher than that by plain MRI (26.67%) or Gd-DTPA enhanced MRI (63.33%). Conclusion Gd-BOPTA dynamic enhanced MRI is superior to plain MRI in detecting SHCC, and to Gd-DTPA enhanced MRI and plain MRI in displaying the capsule of SHCC. The delay imaging is helpful for improving the detecting rate of the lesion. The technique carries no obvious adverse effects and provides a new means in the diagnosis of SHCC.