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1.
Dynamic MR imaging of liver metastases with Gd-EOB-DTPA 总被引:5,自引:0,他引:5
Stern W Schick F Kopp AF Reimer P Shamsi K Claussen CD Laniado M 《Acta radiologica (Stockholm, Sweden : 1987)》2000,41(3):255-262
Purpose: To assess liver and lesion enhancements by dynamic MR imaging after bolus injection of the hepatobiliary contrast agent gadolinium ethoxybenzyldiethylenetriamine-pentaacetic acid (Gd-EOB-DTPA) in patients with liver metastases and to compare the effect of different doses.Material and Methods: A randomized double-blinded trial with doses of 12.5, 25 and 50 μmol/kg Gd-EOB-DTPA was performed in 35 patients with liver metastases. Liver enhancement, tumor enhancement and liver lesion contrast-to-noise (C/N) ratios were calculated from breath-hold gradient echo images (100/5/80°) recorded precontrast and at different times up to 10 min postcontrast.Results: Normal liver showed a characteristic enhancement pattern, with a rapid enhancement in the first 45 s postcontrast and a slight but significant further increase up to 600 s. The initial enhancement in the lesions was also pronounced, but the enhancement was slightly decreased after 240 s postcontrast. At dose levels of 12.5 and 25 μmol/kg Gd-EOB-DTPA, C/N ratios significantly increased compared to baseline from 90 to 600 s. Postcontrast C/N-values obtained using 50 μmol/kg Gd-EOB-DTPA were not significantly increased, except for the examinations 480 s postcontrast.Conclusion: In liver metastases, C/N ratios obtained with doses of 12.5 and 25 μmol/kg Gd-EOB-DTPA were slightly superior to 50 μmol/kg Gd-EOB-DTPA. This finding is probably due to a more pronounced extracellular effect of the contrast medium at higher doses. 相似文献
2.
Hidemasa Takao Hiroyuki AkaiTaku Tajima Shigeru KiryuYasushi Watanabe Hiroshi ImamuraMasaaki Akahane Naoki YoshiokaNorihiro Kokudo Kuni Ohtomo 《European journal of radiology》2011,77(2):325-329
Objective
To quantitatively evaluate the signal intensity of the biliary tract in gadolinium ethoxybenzyl diethylenetriamine pentaacetic acid (Gd-EOB-DTPA)-enhanced magnetic resonance (MR) imaging and to investigate the effect of liver function on the signal intensity of the biliary tract.Materials and methods
A total of 32 patients with and without chronic liver disease (normal liver group, n = 15; chronic liver disease group, n = 17) were included in this study. All patients were prospectively enrolled for evaluation of known or suspected focal liver lesions. In the chronic liver disease group, the etiologies were chronic hepatitis C virus infection (n = 12) and chronic hepatitis B virus infection (n = 5). The median Child-Pugh score was 5 (range, 5-7). Each patient received the standard dose of Gd-EOB-DTPA (0.025 mmol/kg of body weight). Post-contrast T1-weighted MR images were obtained at 5, 10, 15, 20, 25, and 30 min after administration of Gd-EOB-DTPA. Maximum signal intensities (SIs) of the right and left hepatic ducts, common hepatic duct, and common bile duct were measured. Relative signal intensity was calculated as follows: relative SI = maximum SIbile duct/mean SImuscle. Serum albumin level, serum total bilirubin level, prothrombin time, indocyanine green retention rate at 15 min (ICG-R15), and estimated glomerular filtration rate were entered into regression analysis.Results
The signal intensity of the bile duct reached a peak 30 min after administration of Gd-EOB-DTPA. The mean relative signal intensity of the right and left hepatic ducts at the peak time point was not significantly different between the two groups, while increase in signal intensity was delayed in the chronic liver disease group. The mean relative signal intensity of the common hepatic duct and that of the common bile duct at the peak time point were significantly different between the two groups (Wilcoxon rank-sum test, P = 0.03, respectively). Stepwise regression analysis revealed that ICG-R15 was a significant predictor of the signal intensity of the bile duct (right and left hepatic ducts, P = 0.04; common hepatic duct, P = 0.008; common bile duct, P = 0.003).Conclusions
The results of our study demonstrate that the presence of chronic liver disease significantly affects the signal intensity of the bile duct in Gd-EOB-DTPA-enhanced MR imaging. ICG-R15 was only a significant predictor of the signal intensity of the bile duct. The signal intensity of the bile duct may reflect underlying liver function. 相似文献3.
Benndorf M Schelhorn J Dietzel M Kaiser WA Baltzer PA 《European journal of radiology》2012,81(8):e849-e853
Purpose
Gadolinium ethoxybenzyl diethylenetriamine pentaacetic acid (Gd-EOB-DTPA) enhanced liver MRI is widely used for detection and differentiation of focal liver lesions. Diffusion weighted imaging (DWI) including apparent diffusion coefficient (ADC) measurements is increasingly utilised as a fast and, with limitations, quantitative method for liver lesion detection and characterisation. Herein we investigate whether the administration of Gd-EOB-DTPA affects DWI.Materials and methods
31 consecutive patients referred to standardised liver MRI (1.5 T, Gd-EOB-DTPA, 0.025 mmol/kg) were retrospectively reviewed. All underwent a breathhold DWI sequence before and after contrast agent administration (EPI-DWI, TR/TE (effective): 2100/62 ms, b-values: 0 and 800 s/mm2). Patients with previously treated liver lesions were excluded. Signal intensity of lesion, parenchyma and noise on DWI images as well as the ADC value were measured after identification by two observers in consensus using manually placed regions of interest. The reference standard was imaging follow-up determined separately by two radiologists. Data analysis included signal-to-noise (SNR) ratio and contrast-to-noise ratio (CNR) calculations, comparisons were drawn by employing multiple Bonferroni corrected Wilcoxon signed-rank tests.Results
50 malignant and 39 benign lesions were identified. Neither SNR, CNR nor ADC values showed significant differences between pre- and postcontrast DWI. Both pre- and postcontrast ADC values differed significantly between benign and malignant lesions (P < 0.001).Conclusion
We did not identify a significant influence of Gd-EOB-DTPA on DWI of liver lesions. This allows for individual tailoring of imaging protocols according to clinical needs. 相似文献4.
Gupta RT Marin D Boll DT Husarik DB Davis DE Feuerlein S Merkle EM 《European journal of radiology》2012,81(10):2457-2462
Purpose
To compare intraindividual differences in enhancement pattern of hepatic hemangiomas between gadobenate dimeglumine (Gd-BOPTA) and gadoxetate disodium (Gd-EOB-DTPA)-enhanced 3T MR imaging.Materials and methods
This is a HIPAA-compliant, IRB-approved retrospective study with waiver for informed consent granted. From 10/07 to 5/09, 10 patients (2 males, 8 females; mean age, 57.3 years) with 15 hepatic hemangiomas (mean diameter, 4.4 ± 5.6 cm) underwent both Gd-BOPTA- and Gd-EOB-DTPA-enhanced 3T MR imaging (mean interval, 266 days; range, 38–462 days). Diagnosis of hemangioma was based on strict imaging criteria. MR imaging was obtained during three arterial, portal venous, and up to four delayed phases. During each phase, hemangioma-to-liver contrast-to-noise ratio (CNR) was measured for each lesion on both examinations. Statistical analysis was performed using paired Student's t-test.Results
Hemangioma-to-liver CNR peaked during the portal venous phase (Gd-BOPTA: 48.9 ± 65.8, Gd-EOB-DTPA: 0.7 ± 3.8). During all imaging phases except the first arterial phase, hemangioma-to-liver CNR was significantly lower on Gd-EOB-DTPA-enhanced compared to Gd-BOPTA-enhanced MR images (p < 0.05). Notably, Gd-EOB-DTPA yielded negative hemangioma-to-liver CNR (−2.5 ± 2.4) compared to Gd-BOPTA (40.7 ± 56.4) during the first delayed phase (7–8 min after contrast administration), remaining negative for the rest of the delayed phases (up to 26 min after contrast administration).Conclusion
The enhancement patterns of hepatic hemangiomas differs significantly between Gd-BOPTA and Gd-EOB-DTPA-enhanced 3T MR imaging. The smaller dose, shorter plasma half-life, and increased hepatobiliary uptake of Gd-EOB-DTPA leads to a negative CNR of hemangioma-to-liver on delayed phases and could create an imaging pitfall with this agent. 相似文献5.
Tschirch FT Struwe A Petrowsky H Kakales I Marincek B Weishaupt D 《European radiology》2008,18(8):1577-1586
The purpose of this study was to assess the quality of biliary duct visualization using Gd-EOB-DTPA-enhanced magnetic resonance cholangiography (EOB-MRC) in patients with liver cirrhosis. Forty adult patients with liver cirrhosis (cirrhosis group) and 20 adult individuals with normal liver parenchyma (control group) underwent EOB-MRC using T1-weighted GRE imaging up to 180 min after Gd-EOB-DTPA administration. Two observers assessed the visualization of each biliary structure and the overall anatomical visualization of the biliary tree. Child-Pugh, MELD score and laboratory findings were compared. The grade of visualization for each evaluated biliary structure was statistically different in the two groups (P = 0.004 to <0.001). The overall EOB-MRC quality was rated as sufficient for anatomical visualization of the biliary tree in all individuals of the control group 20 min after Gd-EOB-DTPA application, but in only 16/40 patients (40%) of the cirrhosis group within 30 min after application. Analysis of the ROC curves revealed that the cut-off values, for non-sufficient visualization of the biliary tree 20 min after Gd-EOB-DTPA application, were MELD scores > or =11 and total serum bilirubin levels > or =30 micromol/l. Consecutively, EOB-MRC in patients with liver cirrhosis resulted in a decreased or even non-visualization of the biliary tree in a substantial percentage of patients. 相似文献
6.
Olivio F. Donati Michael A. Fischer Natalie Chuck Roger Hunziker Dominik Weishaupt Caecilia S. Reiner 《European journal of radiology》2013
Purpose
To evaluate the accuracy and confidence in diagnosing liver metastases using combined gadolinium-EOB-DTPA (Gd-EOB-DTPA) enhanced magnetic resonance imaging (MRI)/diffusion-weighted imaging (DWI) in comparison to Gd-EOB-DTPA enhanced MRI and DWI alone.Materials and methods
Forty-three patients (age, 58 ± 13 years) with 89 liver lesions (28 benign, 61 malignant) underwent liver MRI for suspected liver metastases. Three image sets (DWI, Gd-EOB-DTPA and combined Gd-EOB-DTPA/DWI) in combination with unenhanced T1- and T2-weighted images were reviewed by three readers. Detection rates of focal liver lesions were assessed and diagnostic accuracy was evaluated by calculating the areas under the receiver-operating-characteristics curve (AUC). Confidence in diagnosis was evaluated on a 3-point scale. Histopathology and imaging follow-up served as the standard of reference.Results
Detection of liver lesions and confidence in final diagnosis for all readers were significantly higher for the combined Gd-EOB-DTPA/DWI dataset than for DWI. The combination of DWI and Gd-EOB-DTPA rendered a significantly higher confidence in final diagnosis (2.44 vs. 2.50) than Gd-EOB-DTPA alone for one reader. For two readers, accuracy in diagnosis of liver metastases was significantly higher for Gd-EOB-DTPA/DWI (AUCs of 0.84 and 0.83) than for DWI datasets (AUCs of 0.73 and 0.72). Adding DWI to Gd-EOB-DTPA did not significantly increase diagnostic accuracy as compared to Gd-EOB-DTPA imaging alone.Conclusion
Addition of DWI sequences to Gd-EOB-DTPA enhanced MRI did not significantly increase diagnostic accuracy as compared to Gd-EOB-DTPA enhanced MRI alone in the diagnosis of liver metastases. However, the increase in diagnostic confidence might justify acquisition of DWI sequences in a dedicated MRI protocol. 相似文献7.
M A Goldberg S Saini P F Hahn T K Egglin P R Mueller 《AJR. American journal of roentgenology》1991,157(4):727-730
We studied the efficacy of T2 measurements at high field strength in distinguishing between liver hemangiomas and hepatic metastases when an ultrafast (single-excitation) MR imaging technique is used. Fourteen patients with known liver tumors were imaged in a 2.0-T prototype ultrafast MR scanner with a spin-echo (infinite TR and TE of 30-340 msec) pulse sequence. Each image was obtained with a total data acquisition time of 20 msec. T2 calculations for hepatic metastases (n = 6) showed a mean of 79.3 +/- 13.5 msec, whereas hemangiomas (n = 8) showed a T2 of 139.8 +/- 18.8 msec (p less than .0001). T2 values of lesions had a smaller relative standard deviation than previously reported, and the range of T2 values of hemangiomas (119-181 msec) and metastases (68-103 msec) did not overlap. Our preliminary results suggest that T2 calculations with ultrafast MR imaging may be useful for differentiating hemangiomas from metastases. We hypothesize that T2 values obtained from ultrafast MR images are more reliable than those obtained from conventional MR images, primarily because of the elimination of T1 information and effects of motion on image signal intensity. 相似文献
8.
Goshima S Kanematsu M Watanabe H Kondo H Mizuno N Kawada H Shiratori Y Onozuka M Moriyama N Bae KT 《European journal of radiology》2011,79(2):e108-e112
Purpose
To retrospectively assess imaging features that help differentiate early-enhancing non-tumorous (EN) hepatic lesions from hepatocellular carcinomas (HCCs) on gadoxetate disodium-enhanced MR imaging.Materials and methods
Our institutional review board approved this retrospective study. We reviewed the studies of 158 patients (92 men and 65 women; age range: 29-91; mean age: 65.6 years) with chronic liver damage, who underwent gadoxetate disodium-enhanced MR imaging at 3T MR scanner. Hypervascular lesions identified during the hepatic artery phase were selected for a study cohort. The location, shape, size (maximum diameter and maximum area), and contrast enhancement signal intensity characteristics of the lesions were evaluated, then compared between the EN and HCC lesions.Results
A total of 65 EN lesions (range: 3-60 mm, mean: 13.6 ± 10.6 mm) from 35 patients and 33 HCCs (range: 9-61 mm, mean: 19.3 ± 12.6 mm) from 20 patients were identified. Lesions were more frequently round or oval in shape for HCCs (n = 29; 88%) than ENs (n = 26; 40%) (P < 0.01). Unexpectedly, some ENs (n = 12; 18%) showed hypointensity on hepatocyte-phase, and 6 (50%) of them were T2 hyperintense. For lesions smaller than 2 cm (9 ENs and 21 HCCs) on hepatic arterial-phase images, the mean area of hypointensity in hepatocyte-phase (54.2 ± 33.1 mm2) was significantly smaller than those of the corresponding hyperintensity in hepatic arterial-phase (97.1 ± 42.0 mm2) for EN lesions (P = 0.019), whereas no significant difference in area was found for HCCs.Conclusion
EN lesions may occasionally present with hypointensity during the hepatocyte-phase; presenting a diagnostic dilemma. In this situation, EN lesions may be differentiated from HCCs when a hypointense area in hepatocyte-phase is smaller than the corresponding hypervascular area in hepatic-arterial phase. 相似文献9.
Tsutomu Tamada Katsuyoshi Ito Teruki Sone Akihiko Kanki Tomohiro Sato Hiroki Higashi 《European journal of radiology》2011,80(3):e207
Objective
The purpose of this study was to assess the difference in the activity of biliary and renal excretion between normal and cirrhotic livers on contrast-enhanced MR imaging obtained with gadolinium ethoxybenzyl diethylenetriaminepentaacetic acid (Gd-EOB-DTPA).Methods
A total of 78 patients with cirrhotic liver (n = 44) and with normal liver (n = 34) underwent multi-phase Gd-EOB-DTPA enhanced MR imaging (arterial, portal, equilibrium, and three hepatobiliary phases (10, 15 and 20 min HP), respectively), and these contrast-enhanced images were qualitatively and quantitatively evaluated for the differences of the biliary and renal excretion between normal and cirrhotic livers.Results
The timing of biliary excretion of contrast agents in the cirrhotic liver was significantly slower than that in the normal liver (P < 0.001). The degree of contrast enhancement in the common bile duct in the normal liver was significantly better than that in the cirrhotic liver (P = 0.003). Contrast agents were demonstrated in the duodenum at 20 min HP in 8/44 (18%) cirrhotic liver while they were seen in 15/34 (44%) normal liver (P = 0.013). The enhancement effects of renal medulla and portal vein at 20 min HP in the cirrhotic liver were significantly higher than those of normal liver (P = 0.043 and P < 0.001, respectively).Conclusion
Biliary excretion of Gd-EOB-DPTA was impaired in cirrhotic livers in comparison with normal livers while renal excretion of Gd-EOB-DPTA was increased. 相似文献10.
Satoshi Kobayashi Osamu Matsui Toshifumi Gabata Wataru Koda Tetsuya Minami Yasuji Ryu Kazuto Kozaka Azusa Kitao 《European journal of radiology》2012
Purpose
To elucidate the incidence of signal intensity patterns of borderline lesions of hepatocellular carcinoma (HCC) on hepatobiliary phase Gd-EOB-DTPA (EOB) enhanced MRI and clarify the natural histories of these lesions.Materials and methods
Total 99 borderline lesions of HCC were identified by angiography-assisted CT. The signal intensity of borderline lesions on hepatobiliary phase of EOB-enhanced MRI was analyzed. Progress rate from borderline lesions to hypervascular HCC was calculated with the Kaplan–Meier method among each signal intensity groups of nodules.Results
On hepatobiliary phase of EOB-enhanced MRI, 41.4% of the borderline lesions showed hypo-, 42.4% showed iso-, and 16.2% showed hyperintense, compared to background liver. Overall progress rates from borderline lesions to HCC were 10% in 1-year, 14% in 2-year and 20% in 3-year follow-up period. Progress rates to HCC in hypointense borderline lesions were 17% in 1-year, 28% in 2-year and 41% in 3-year follow-up period, and in isointense borderline lesions were 7% in 1-year, 7% in 2-year and 7% in 3-year follow-up period. No hyperintense borderline lesions progressed to HCC in follow-up period.Conclusion
Although borderline lesions of HCC may show hypo-, iso- and hyperintensity on hepatobiliary phase of EOB-enhanced MRI, hypointense borderline lesions are high risk to progress HCC. 相似文献11.
由于肝脏乏血供病变的常规影像表现相似,故术前对病变的良恶性鉴别诊断有一定困难。MRI是肝脏病变诊断最有价值的成像方法,利用非特异性细胞外对比剂钆塞酸二钠(Gd-EOB-DTPA)在肝胆期可以被肝细胞特异性摄取的特点,能够提高病变的检出率和诊断准确性。就多种肝脏乏血供良恶性病变的病生理特点及Gd-EOB-DTPA的MR影像征象予以综述。 相似文献
12.
13.
Tamada T Ito K Yoshida K Kanki A Higaki A Tanimoto D Higashi H 《European journal of radiology》2011,80(3):e284-e288
Objective
To compare three different injection methods for optimizing hepatic arterial phase of gadolinium ethoxybenzyl diethylenetriaminepentaacetic acid (Gd-EOB-DTPA) enhanced MR imaging.Methods
Arterial phase images were obtained after the injection of contrast agent at a rate of 3 mL/s with diluted Gd-EOB-DTPA (dilution method) in 27 patients, 3 mL/s with undiluted Gd-EOB-DTPA (3 mL method) in 26 patients and 1 mL/s with undiluted Gd-EOB-DTPA (1 mL method) in 28 patients. In the quantitative evaluation, signal-to-phantom ratios (SPR) of the liver parenchyma, pancreas, renal cortex, portal vein and aorta were evaluated. In the qualitative evaluation, the seven items for image quality of hepatic arterial phase were assessed, and the total score of all items in each subject was calculated.Results
The score of enhancement of abdominal aorta and total score of seven items in 1 mL method were significantly higher than those in 3 mL method. The SPR of the liver parenchyma in 3 mL method was significantly higher than that in 1 mL method, suggesting substantial hepatic inflow from portal venous return.Conclusion
For the optimal arterial phase imaging, injection rate of 1 mL/s with undiluted Gd-EOB-DTPA is convenient and preferable, compared with other two methods, based on our qualitative analysis. 相似文献14.
目的 :探讨立体定向放射治疗原发性肝癌后MRI在鉴别复发性肝癌和放射性肝损伤的诊断价值。方法 :12名原发性肝癌立体定向放射治疗后怀疑复发的患者行MRT1WI、T2 WI和T1WI动态增强检查 ,分别测量复发性肝癌和放射性肝损伤的T1WI、T2 WI的信噪比及强化程度 ,并进行统计学分析。结果 :复发性肝癌和放射性肝损伤在T1WI和T2 WI上信号表现相似 ,两者SNR对比差异无显著性意义。增强扫描后 ,复发性肝癌在动脉期强化 ,静脉期及延迟期呈低信号 ,强化持续时间短 ;放射性肝损伤动脉期强化 ,强化持续时间长 ,静脉期及延迟期亦呈高信号 ,两者明显不同。结论 :MRI动态增强可有效的鉴别复发性肝癌和放射性肝损伤 相似文献
15.
Sonja Kinner Verena Steinweg Stefan Maderwald Arnold Radtke Georgios Sotiropoulos Michael Forsting Tobias Schroeder 《European journal of radiology》2014
Introduction
Detailed knowledge of the biliary anatomy is essential to avoid complications in living donor liver transplantation. The aim of this study was to determine the optimal dosage of Gd-EOB-DTPA for contrast-enhanced magnetic resonance cholangiography (ce-MRC) with reference to contrast-enhanced CT cholangiography (ce-CTC).Materials and methods
30 potential living liver donors (PLLD) underwent both ce-CTC and ce-MRC. Ten candidates each received single, double or half-dose Gd-EOB-DTPA. Ce-MRC images with and without inversion recovery pulses (T1w ± IR) were acquired 20–30 min after intravenous contrast injection. Image data was quantitatively and qualitatively reviewed by two radiologists based on a on a 5-point scale. Data sets were compared using a Mann–Whitney-U-test or Wilcoxon-rank-sum-test. Kappa values were also calculated.Results
All image series provided sufficient diagnostic information both showing normal biliary anatomy and variant bile ducts. Ce-CTC showed statistically significant better results compared to all ce-MRC data sets. T1w MRC with single dose Gd-EOB-DTPA proved to be superior to half and double dose in subjective and objective evaluation without a statistically significant difference.Conclusions
Ce-MRC is at any dosage inferior to ce-CTC. As far as preoperative planning of bile duct surgery is focused on the central biliary anatomy, ce-MRC can replace harmful ce-CTC strategies, anyway. Best results were seen with single dose GD-EOB-DTPA on T1w MRC+IR. 相似文献16.
目的:比较静脉注射钆塞酸二钠(Gd-EOB-DTPA)和钆喷酸葡胺(Gd-DTPA)的动脉期呼吸伪影,寻求减少Gd-EOB-DTPA动脉期呼吸伪影的可能方案.方法:搜集在1年内行Gd-EOB-DTPA和Gd-DTPA磁共振动态增强扫描的患者75例,由两位有经验的磁共振医师采用盲法对两种对比剂扫描方案的动脉期、门脉期及延迟期图像采用5分法评分,以≤3分定义为中重度伪影.两种对比剂扫描方案的呼吸伪影比较采用Wilcoxon秩和检验和配对卡方检验.结果:Gd-EOB-DTPA组发生动脉晚期呼吸伪影的比例明显高于Gd-DTPA组(分别为49.3%和6.7%,Z=-5.058,P<0.001),其中中重度伪影的比例亦明显高于Gd-DTPA(分别为33.33%和2.67%,x2=21.04,P<0.001);而Gd-EOB-DT-PA组动脉早期出现呼吸伪影和中重度呼吸伪影的比例与Gd-DTPA组差异无统计学意义(Z=-1.513,P=0.130;x2=0.25,P=0.625).结论:静脉注射Gd-EOB-DTPA较Gd-DTPA更易引起动脉期伪影,减少单期屏气时间和采用动脉期监测技术可能提高Gd-EOB-DTPA动脉期采集的图像质量. 相似文献
17.
目的:探讨Carebolus技术在肝癌Gd—EOB-DTPAMR动态增强肝脏动脉期扫描中的价值。方法:纳入本院2012年3月-12月行Gd—EOH_DTPA动态MR增强的72例患者,分为A、B两组,A组行Carebolus技术动态扫描,B组行定时延时动脉期扫描,分析Gd—EOB-DTPA增强后患者胸主动脉下段、腹腔干信号强度、门静脉和肝癌病灶强化情况,采用独立样本t检验,独立样本的Wilcoxon符号秩和检验及KruskalWallisH统计两组问的差别。结果:A、B两组Gd—EOB-DTPA增强后胸主动脉下段信号强度分别为15.5±7.8和21.3±11.3,腹腔干信号强度分别为22.5±8.2和31.0±14.0,两组间差异均有统计学意义(P=0.0065,P=0.0015)。A、B两组动脉期门静脉无强化率分别为53%和4%,差异有统计学意义(P=0.000)。A、B两组动脉期肝癌病灶最优强化率分别为79%和46%,差异有统计学意义(P=0.005)。结论:Carebolus技术对肝癌病灶动脉增强特点的显示明显优于常用的动脉延时扫描技术。Carebolus技术可作为常规扫描技术用于肝癌Gd-E013-DTPAMR动态增强肝脏动脉期扫描。 相似文献
18.
The pseudocapsule in hepatocellular carcinoma: correlation between dynamic MR imaging and pathology 总被引:7,自引:1,他引:6
L. Grazioli L. Olivetti C. Fugazzola A. Benetti C. Stanga E. Dettori C. Gallo L. Matricardi A. Giacobbe A. Chiesa 《European radiology》1999,9(1):62-67
Nodular hepatocellular carcinoma (HCC) is characterized by the presence of a pseudocapsule (constructed usually from connective
fibrous tissue) that appears hypointense on T1- and T2-weighted spin-echo (SE) and gradient-echo (GE) MR imaging sequences
without a contrast medium. The presence of vascular structures inside the tumor, which are verified by histological exam,
affects enhancement of the PC after administrating the contrast medium: The impregnation is more evident in the dynamic study
but also persists on the delayed T1-weighted SE images. The accuracy of MR in detecting the pseudocapsule of HCC and contrast
enhancement of the pseudocapsule during dynamic studies were evaluated and related to pathological findings. Thirty-seven
HCC were examined in 33 patients and afterwards resected. In capsulated nodules, besides usual hematoxylin, eosin, and trichrome
stainings, histochemical and immunohistochemical methods were performed. On a 1.5-T MR unit, T1- and T2-weighted SE and GE
FLASH 2D sequences after intravenous injection of Gd-DTPA (dynamic study) were used. In a later phase, T1-weighted SE sequences
were repeated. Histologically, the pseudocapsule (thickness 0.2–6 mm) was present in 26 of 37 nodules (70 %). The dynamic
study was the most suitable technique to show the pseudocapsule, which was recognized in 80.7 % (21 of 26 nodules). In 5 of
26 cases, the pseudocapsule, not demonstrated by MR, was thinner than 0.4 mm. In 16 of 21 cases, in the early portal phase
(30–60 s), the pseudocapsule had an early enhancement, which was more evident later; in 5 of 21 cases the enhancement was
observed only in the late portal phase (1–2 min). At histological examination, 14 of 16 pseudocapsules with early enhancement
showed a more prominent vasculature than those with enhancement in the equilibrium phase. Magnetic resonance was a reliable
tool in demonstrating the pseudocapsule of HCC. The histological examination demonstrated a good correlation between the enhancement
behavior and the vessel number of the pseudocapsule.
Received: 28 July 1997; Revision received: 9 February 1998; Accepted: 20 March 1998 相似文献
19.
Huwart L Salameh N ter Beek L Vicaut E Peeters F Sinkus R Van Beers BE 《European radiology》2008,18(11):2535-2541
The purpose of this study was to prospectively compare the performance of magnetic resonance (MR) elastography using echo-planar
and spin-echo imaging for staging of hepatic fibrosis. Twenty-four patients who had liver biopsy for suspicion of chronic
liver disease had MR elastography performed with both spin-echo and echo-planar sequences. At histology, the fibrosis stage
was assessed according to METAVIR. The data acquisition time was about 20 min using spin-echo, and only 2 min using echo-planar
imaging. The hepatic signal-to-noise ratios were similar on both images (22.51 ± 5.37 for spin-echo versus 21.02 ± 4.76 for
echo-planar, p = 0.33). The elasticity measurements and the fibrosis stages were strongly correlated. The Spearman correlation coefficients
were r = 0.91 (p < 0.01) with spin-echo and r = 0.84 (p < 0.01) with echo-planar sequences. These correlation coefficients did not differ significantly (p = 0.17). A strong correlation was also observed between spin-echo and echo-planar elasticity (r = 0.83, p < 0.001), without systematic bias. The results of our study showed that echo-planar imaging substantially decreased the data
acquisition time of MR elastography, while maintaining the image quality and diagnostic performance for staging of liver fibrosis.
This suggests that echo-planar MR elastography could replace spin-echo MR elastography in clinical practice.
This work was supported by grants FRSM 3.4578.00 and 3.4580.06 from the Fonds National de la Recherche Scientifique, Belgium. 相似文献
20.
N. Verloh M. Haimerl J. Rennert R. Müller-Wille C. Nießen G. Kirchner M.N. Scherer A.G. Schreyer C. Stroszczynski C. Fellner P. Wiggermann 《European journal of radiology》2013