CAJ | 학술논문

目的：评估钆塞酸二钠(gadolinium ethoxybenzyl diethylenetriamine-pentaacetic acid，Gd-EOB-DTPA)增强磁共振成像(magnetic resonance imaging， MRI)延迟10 min的肝胆期是否能够满足肝功能正常患者肝脏局灶性病变的检出和诊断。材料与方法38位存在肝脏局灶性病变的肝功能正常患者，经静脉注射Gd-EOB-DTPA后分别于25 s、60 s、180 s行MRI动态增强扫描，延迟10 min和20 min行肝胆期扫描。测量肝脏和竖脊肌的信号强度(signal intensity，SI)，分别计算增强后肝脏和竖脊肌SI相对增加率、肝脏与竖脊肌SI比值、肝脏信号噪声比(signal to noise ratio，SNR)、肝胆期高信号和低信号病灶SNR及对比噪声比(contrast to noise ratio，CNR)，记录Gd-EOB-DTPA经胆道排泄的时间，比较10 min与20 min肝胆期肝脏的信号强度和病灶的显示情况。结果注射Gd-EOB-DTPA后，相对于动态增强，肝实质信号在10 min肝胆期明显增加，随后趋于稳定。10 min与20 min肝胆期之间，肝脏SI相对增加率、竖脊肌SI相对增加率及肝脏与竖脊肌SI比值差异均有统计学意义(P＜0.05)，肝脏SNR差异无统计学意义(P＞0.05)，低信号病灶SNR差异无统计学意义(P＞0.05)，高信号病灶SNR差异有统计学意义(P＜0.05)，低信号及高信号病灶CNR差异均无统计学意义(P＞0.05)。26例注射Gd-EOB-DTPA后10 min胆道可见对比剂排泄，占68.42%。结论 Gd-EOB-DTPA增强MRI延迟10 min的肝胆期能够满足肝功能正常患者肝脏局灶性病变的检出和诊断。
목적：평고구새산이납(gadolinium ethoxybenzyl diethylenetriamine-pentaacetic acid，Gd-EOB-DTPA)증강자공진성상(magnetic resonance imaging， MRI)연지10 min적간담기시부능구만족간공능정상환자간장국조성병변적검출화진단。재료여방법38위존재간장국조성병변적간공능정상환자，경정맥주사Gd-EOB-DTPA후분별우25 s、60 s、180 s행MRI동태증강소묘，연지10 min화20 min행간담기소묘。측량간장화수척기적신호강도(signal intensity，SI)，분별계산증강후간장화수척기SI상대증가솔、간장여수척기SI비치、간장신호조성비(signal to noise ratio，SNR)、간담기고신호화저신호병조SNR급대비조성비(contrast to noise ratio，CNR)，기록Gd-EOB-DTPA경담도배설적시간，비교10 min여20 min간담기간장적신호강도화병조적현시정황。결과주사Gd-EOB-DTPA후，상대우동태증강，간실질신호재10 min간담기명현증가，수후추우은정。10 min여20 min간담기지간，간장SI상대증가솔、수척기SI상대증가솔급간장여수척기SI비치차이균유통계학의의(P＜0.05)，간장SNR차이무통계학의의(P＞0.05)，저신호병조SNR차이무통계학의의(P＞0.05)，고신호병조SNR차이유통계학의의(P＜0.05)，저신호급고신호병조CNR차이균무통계학의의(P＞0.05)。26례주사Gd-EOB-DTPA후10 min담도가견대비제배설，점68.42%。결론 Gd-EOB-DTPA증강MRI연지10 min적간담기능구만족간공능정상환자간장국조성병변적검출화진단。
Objective:To assess whether, in patients with normal liver function, a hepatobiliary delay time of 10 min after Gd-EOB-DTPA injection is sufifcient for lesion detection and diagnosis.Materials and Methods:A total of 38 patients with normal liver function who has liver lesion were included in this study, and MRI was performed after intravenous Gd-EOB-DTPA, followed by dynamic contrast phases at 25 s, 60 s, 180 s and hepatobiliary phases at 10 min and 20 min. We’ve measured the signal intensity (SI) of liver and erector spinae muscle, and then calculating liver ratio, muscle ratio, liver-muscle ratio, liver SNR, lesion SNR (hypo- and hyperintense lesions) and CNR (hypo- and hyperintense lesions), recording the time of contrast agent excrete in bile ducts meanwhile. In all, we compared the differences of liver SI and the ability to show lesion’s information between 10 min and 20 min hepatobiliary phases.Results:Following enhancement, liver SI increased signiifcantly up to 10 min, and subsequently stabilized. Differences of liver ratio, muscle ratio and liver-muscle ratio between hepatobiliary phases of 10 min and 20 min were statistically signiifcant(P<0.05). There was no statistical difference of liver SNR between hepatobiliary phases of 10 min and 20 min(P>0.05). Difference of hyperintense lesions SNR between 10 min and 20 min hepatobiliary phases was statistically signiifcant(P<0.05), but hypointense lesions SNR wasn’t (P>0.05). Neither hypo- nor hyperintense lesions CNR has statistical difference between 10 min and 20 min hepatobiliary phases(P>0.05). Besides, biliary contrast agent excretion was ifrst observed after 10 min in 26 patients (68.42%).Conclusion:A hepatobiliary delay time of 10 min after Gd-EOB-DTPA injection is sufifcient for lesion detection and diagnosis in patients with normal liver function.