Hepatocellular carcinoma 20 mm or smaller in cirrhosis patients: early magnetic resonance enhancement by gadoxetic acid compared with gadopentetate dimeglumine
Hepatocellular carcinoma 20 mm or smaller in cirrhosis patients: early magnetic resonance enhancement by gadoxetic acid compared with gadopentetate dimeglumine
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DOI：
10.1007/s12072-013-9467-7
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发表时间：
2013
影响因子：
6.6
通讯作者：
Caizhong Chen;Sheng-xiang Rao;Ying Ding;Shu-Jie Zhang;Feng Li;Q. Gao;M. Zeng
中科院分区：
文献类型：
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作者：
Caizhong Chen;Sheng-xiang Rao;Ying Ding;Shu-Jie Zhang;Feng Li;Q. Gao;M. Zeng
目的评价加多辛酸与加多戊二胺在同一肝硬化患者早期动态磁共振增强成像（MRI）中对20mm及以下肝细胞癌（HCC）增强模式及肝血管增强效果的差异。方法我们回顾了34例42例组织学证实的hcc（中位直径14.5 mm）患者使用加多己酸和加多戊二酸二聚胺的MR图像。计算肝细胞癌与肝动脉、门静脉的增强百分比（pe）及肝细胞癌与肝脏的相对对比（RCs），并进行统计学分析。结果肝动脉期（肝动脉期p= 0.0256，肝动脉期p< 0.0001）和门静脉期（肝门静脉期p< 0.0001）肝动脉期、肝动脉期、门静脉期肝动脉、门静脉的pe均明显低于加多戊二酸组。加多己酸与加多己酸二聚胺在动脉期HCC与肝脏之间的RC显著降低（p= 0.0422），但在门脉期无显著差异（p= 0.1133）。42例结节中有41例（97.62%）表现为动脉血管增生。其中31个（75.61%）结节在门静脉期呈低信号，22个（53.66%）结节在门静脉期呈低信号（p= 0.038）。结论与加多戊酸二聚胺相比，加多戊酸增强MRI表现出不同的下动脉强化模式，在肝细胞癌门静脉期表现出更快的低信号。肝硬化患者肝动脉、门静脉强化程度明显降低。
PurposeTo evaluate the differences in enhancement pattern of hepatocellular carcinoma (HCC) 20 mm or smaller and enhancement effects of hepatic vessels on early dynamic contrast-enhanced magnetic resonance imaging (MRI) obtained with gadoxetic acid and gadopentetate dimeglumine in the same patients with cirrhosis.MethodsWe reviewed MR images using gadoxetic acid and gadopentetate dimeglumine in the same 34 patients with 42 histologically confirmed HCCs (median diameter, 14.5 mm). The percentage enhancements (PEs) of HCC, the hepatic artery and portal vein and relative contrasts (RCs) between HCC and the liver were calculated and analyzed statistically.ResultsThe PEs of HCC, the hepatic artery and portal vein were significantly lower for gadoxetic acid in comparison with gadopentetate dimeglumine in the arterial phase (p= 0.0256 for HCC,p< 0.0001 for hepatic artery) and portal phase (p< 0.0001 for HCC, portal vein). The RC between HCC and the liver was significantly lower for gadoxetic acid in comparison with gadopentetate dimeglumine in the arterial phase (p= 0.0422), but was not significantly different in the portal phase (p= 0.1133). Forty-one of the 42 (97.62 %) nodules showed arterial hypervascularization. Of these, 31 (75.61 %) nodules were hypointense in the portal phase for gadoxetic acid, and 22 (53.66 %) were hypointense for gadopentetate dimeglumine (p= 0.038).ConclusionsCompared with gadopentetate dimeglumine, gadoxetic acid-enhanced MRI demonstrated a different enhancement pattern of inferior arterial enhancement and was more rapidly hypointense in the portal phase for HCC. It showed markedly lower enhancement for hepatic artery and portal vein in the patients with cirrhosis.