Comparison of Enhancement Patterns of Histologically Confirmed Hepatocellular Carcinoma Between Gadoxetate- and Ferucarbotran-enhanced Magnetic Resonance Imaging
Comparison of Enhancement Patterns of Histologically Confirmed Hepatocellular Carcinoma Between Gadoxetate- and Ferucarbotran-enhanced Magnetic Resonance Imaging
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DOI：
10.1002/jmri.22333
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发表时间：
2010-10-01
影响因子：
4.4
通讯作者：
Murakami, Takamichi
中科院分区：
文献类型：
--
作者：
Okada, Masahiro;Imai, Yasuharu;Murakami, Takamichi
目的：比较钆塞酸盐和ferucarbotran增强MRI之间肝细胞癌（HCC）和异型增生结节（DN）的增强模式。材料和方法：从超声监测慢性肝病HCC招募的患者参加了这项前瞻性研究，由机构审查委员会批准。36例患者的37例组织学证实的HCC，包括22例高分化HCC（wHCC），15例中分化至低分化HCC（mpHCC）和4例DN，接受了钆塞酸盐增强和阿魏酸增强MRI。我们比较了钆塞酸盐增强MRI和阿魏酸增强MRI的肝胆期图像，比较了HCC和DN相对于周围肝实质的信号强度。结果：在增强MRI上，14例（14/22; 63%）wHCC表现为等信号，14例（14/22; 63%）mHCC表现为高信号，14例（14/22; 63%）wHCC表现为等信号。钆塞酸盐增强MRI肝胆期，13例mpHCC（13/15; 86%）和20例wHCC（20/22; 91%）呈低信号。两个DN和其他两个显示等和低信号，分别在钆塞酸盐增强MRI，而所有DN显示等信号的ferucarbotran增强MRI。在wHCC中，钆塞酸-造影剂后比值显著低于阿魏酸-造影剂后比值（P = 0.015）。结论：在逐步性肝癌发生过程中，钆塞酸靶向肝细胞的摄取功能比阿魏酸靶向枯否细胞的摄取功能更敏感。
Purpose: To compare enhancenent patterns of hepatocellular carcinoma (HCC) and dysplastic nodule (DN) between gadoxetate- and ferucarbotran-enhanced MRI.Materials and Methods: Patients recruited from ultrasound surveillance for HCC in chronic liver diseases were enrolled in this prospective study approved by institutional review board. Thirty-six patients with 37 histologically proven HCC, including 22 well-differentiated HCCs (wHCC), 15 moderately to poorly differentiated HCCs (mpHCCs), and 4 DNs, underwent gadoxetate-enhanced and ferucarbotran-enhanced MRI. We compared hepatobiliary phase image of gadoxetate-enhanced MRI with ferucarbotran-enhanced MR image regarding signal intensity of HCC and DN relative to surrounding liver parenchyma. We calculated contrast ratios between tumor and liver on pre-enhancement, hepatobiliary phase of gadoxetate-enhanced MRI and ferucarbotran-enhanced MRI.Results: On ferucarbotran-enhanced MRI, all mpHCCs showed hyper-intensity, while 14 wHCCs (14/22; 63%) showed iso-intensity. On hepatobiliary phase of gadoxetate-enhanced MRI, 13 mpHCCs (13/15; 86%) and 20 wHCCs (20/22; 91%) showed hypo-intensity. Two DNs and the other two showed iso- and hypo-intensity, respectively, on gadoxetate-enhanced MRI, whereas all DNs revealed iso-intensity on ferucarbotran-enhanced MRI. Gadoxetate-postcontrast ratio was significantly lower than ferucarbotran-postcontrast ratio in wHCC (P = 0.015).Conclusion: The uptake function of hepatocytes that are targeted by gadoxetate is more sensitive than that of Kupffer cells targeted by ferucarbotran in stepwise hepatocarcinogenesis.