Double-Dose Gadoxetic Acid-Enhanced Magnetic Resonance Imaging in Patients With Chronic Liver Disease
Double-Dose Gadoxetic Acid-Enhanced Magnetic Resonance Imaging in Patients With Chronic Liver Disease
复制标题
DOI：
10.1097/rli.0b013e3181f9c487
复制
发表时间：
2011-02-01
影响因子：
6.7
通讯作者：
Araki, Tsutomu
中科院分区：
文献类型：
--
作者：
Motosugi, Utaroh;Ichikawa, Tomoaki;Araki, Tsutomu
目的：探讨双剂量加多西酸（Gd-EOB-DTPA）对慢性肝病患者动脉期和肝细胞期图像的病变-肝对比比及动脉期图像质量的影响。材料与方法：本研究经我院伦理委员会批准。本研究纳入了28例54例肝细胞癌患者（13例Child-Pugh A级，15例B级）。所有患者均接受Gd-EOB-DTPA标准剂量（0.025 mmol/kg体重）和双剂量（0.050 mmol/kg体重）。在动脉和肝细胞期图像中评估病变与肝脏的对比。用4分制评价动脉期图像中的伪影。采用Wilcoxon符号秩检验进行比较。结果：Child-Pugh B级病变患者双剂量后肝细胞期病变肝对比明显高于标准剂量后（标准剂量vs双剂量；0.20 +/- 0.16 vs 0.25 +/- 0.17; P < 0.0001）；然而，在Child-Pugh A类疾病患者中，标准剂量和双剂量后的比例相等（0.35 +/- 0.18 vs. 0.35 +/- 0.14; P = 0.3038）。双剂量显著增加动脉期病变与肝脏的对比（0.34 +/- 0.19 vs. 0.58 +/- 0.33; P < 0.0001）。标准剂量后，动脉期图像中的伪影更为明显（读卡器1为2.7 vs. 2.4，读卡器2为2.8 vs. 2.4; P = 0.0195和0.0010）。结论：双剂量Gd-EOB-DTPA对慢性肝病患者肝细胞癌的动脉强化效果较好，对Child-Pugh B类疾病患者肝细胞期图像的病灶-肝脏对比也有改善。
Objectives: To determine the effect of double-dose gadoxetic-acid (Gd-EOB-DTPA) on lesion-liver contrast ratio in arterial-and hepatocyte-phase images and arterial-phase image quality in patients with chronic liver disease.Materials and Methods: The ethics committee at our institute approved this study. This study included 28 patients (13 with Child-Pugh class A and 15 with class B) with 54 hepatocellular carcinomas. All patients received the standard Gd-EOB-DTPA dose (0.025 mmol/kg bodyweight) and double dose (0.050 mmol/kg bodyweight). The lesion-liver contrast ratio was evaluated in arterial-and hepatocyte-phase images. The artifacts in arterial-phase images were evaluated with a 4-point scale. Wilcoxon signed-rank test were used for comparisons.Results: The hepatocyte-phase lesion-liver contrast ratio after the double dose was significantly higher than that after the standard dose in patients with Child-Pugh class B disease(standard dose vs. double dose; 0.20 +/- 0.16 vs. 0.25 +/- 0.17; P < 0.0001); however, the ratio after both the standard and double doses was equivalent in patients with Child-Pugh class A disease (0.35 +/- 0.18 vs. 0.35 +/- 0.14; P = 0.3038). The double dose significantly increased the arterial-phase lesion-liver contrast ratio (0.34 +/- 0.19 vs. 0.58 +/- 0.33; P < 0.0001). The artifacts in the arterial-phase images were more prominent after the standard dose (2.7 vs. 2.4 for reader 1, 2.8 vs. 2.4 for reader 2; P = 0.0195 and 0.0010).Conclusions: Administration of double dose of Gd-EOB-DTPA provided better arterial enhancement of hepatocellular carcinomas in patients with chronic liver disease, and also improved the lesion-liver contrast in hepatocyte-phase images in patients with Child-Pugh class B disease.