肝脏占位性病变的磁共振成像研究：超顺磁性氧化铁与钆喷替酸葡甲胺的比较

通过与常用造影剂钆喷替酸葡甲胺（Gd-DTPA）的配对实验来评价新型造影剂超磁性氧化铁（SPIO）对有肝占位的检出率和定性诊断能力。材料和方法：53个病例132个肝占位首日行平扫及Gd-DTPA的动态增强扫描，次日行SPIO增强扫描，对照病理及临床随访证实结果，探讨各种占位SPIO增强扫描的强化特点，比较平扫联合Gd-DTPA动态增强扫描与平扫联合SPIO增强扫描的病灶检出率和定性诊断率。结果：SPIO增强扫描良性肝占位的信号随肝实质降低，而恶性肝占位的信号保持不变。平扫联合SPIO增强扫描的病灶检出率和定性诊断率较平扫联合Gd-DTPA增强扫描的略高，但统计学上相差不显著。结论：SPIO强化的原理、强化方式直至临床应用方法、特点与Gd-DTPA均完全不同，两者可相互补充和印证，当Gd-DTPA动态增强扫描定性诊断困难时应积极行SPIO增强扫描。

Enhanced MR Imaging of Hepatic Lesion:Comparison of Superparamagnetic Iron Oxide with Gd-DTPA

Purpose:To evaluate the efficacy of superparamagnetic iron oxide(SPIO) in the detection of focal hepatic lesions compared with Gd-DTPA enhanced MR images.Materials and Method:The study included 53 patients with 132 focal hepatic lesions.Plain and Gd-DTPA dynamic enhanced MR images were obtained in the first day and SPIO enhanced MR images were obtained in the second day.Correlated with findings from histopathologic and clinical follow-up comfirmed,the characteristic of SPIO enhanced MR images of focal hepatic lesions were discussed.Also the rate of detection of hepatic lesions and the accuracy of characteristic diagnosis of the two contrast media were compared.Results:SPIO cause a signal decrease of benign lesions but not malignant ones.For plain combining SPIO enhanced MRI,the rate of detection of hepatic lesions and the accuracy of characteristic diagnosis was slightly high than that of plain combining Gd-DTPA dynamically enhanced MRI,but there is no statistical significance.Conclusion:The theory and mode of SPIO enhancement and even the ways of SPIO appliance is quite different from that of Gd-DTPA.The two can complement and confirm each other.When the diagnosis of Gd-DTPA enhanced MRI have difficulties,SPIO enhanced MRI should be applied.