钆布醇和钆贝葡胺在磁共振成像诊断肺癌脑转移中的对照研究

目的对比研究2种不同钆对比剂钆布醇(Gadobutrol)和钆贝葡胺(Multihance)在磁共振T1WI增强扫描对肺癌脑转移的诊断价值。方法对21例肺癌临床怀疑脑转移的患者,用Siemens MAGENETOM Trio3.0T磁共振成像仪及其配备的8通道头部线圈行头部增强扫描。对比剂剂量按0.1mmol/kg体质量计算,第1次使用钆贝葡胺(0.5mol/L),第2次使用钆布醇(1.0mol/L),2次扫描间隔24～72h,期间患者未进行其他治疗。由两位有丰富经验的神经放射医生比较两者对转移瘤的显示情况,病灶/正常脑白质增强前、后的信噪比(SNR),病灶与对侧正常脑白质增强后对比噪声比及增强百分比。结果 1例患者由于两次扫描之间进行了放疗而被排除,其余20例患者2种对比剂增强后均发现15例有脑转移病灶,共计35个病灶。钆布醇和钆贝葡胺增强前、后病灶/脑白质的SNR,病灶与对侧正常脑白质增强后对比噪声比和增强百分比差异均无统计学意义(t=0.545,P=0.592;t=1.143,P=2.267;t=0.592,P=0.557;t=0.473,P=0.639)。结论按0.1mmol/kg体质量剂量给药时,相对于0.5mol/L钆贝葡胺,1.0mol/L钆布醇只需一半的剂量即能获得高质量的中枢神经系统成像,达到同样的临床诊断效果。

Comparison of the Efficacy of Gadobutrol and Multihance in Contrast-enhanced MRI for Diagnosis of Brain Metastasis in Lung Cancer

Objective To investigate the diagnostic efficacy of gadobutrol for assessing brain metastases in lung cancer patients in comparison with multihance.Methods 21 patients with lung cancer suspected of brain metastasis were enrolled in this study.All patients underwent twice MRI scans on a 3.0T MRI scanner(Siemens MAGENETOM Trio) with 8-channel head coil,first with 0.5 mol/L multihance and then with 1.0 mol/L gadobutrol as contrast agent.The dosage of contrast agent was set at 0.1 mmol/kg body mass.The interval between the two scans was 24-72 hours.The detection and delineation of lesions were evaluated visually.The signal-to-noise ratios(SNR),contrast-to-noise ratios(CNR) of lesion to normal brain white matter and the percentage of lesion enhancement were calculated and compared between the two scans by 2 experienced neuro-radiologists.Results One patient was excluded because he received radiation therapy between the two scans.15 patients were found to have brain metastases with a total of 35 lesions.There were no statistical differences between the two scans in SNR,CNR and percentage enhancement for both normal brain and lesions(t=0.545,P=0.592;t=1.143,P=2.267;t=0.592,P=0.557;t=0.473,P=0.639).Conclusion Half-dose gadobutrol(1.0 mol/L) can achieve the same enhancement effects compared with full-dose multihance(0.5 mol/L).