Gd-EOB-DTPA-enhanced magnetic resonance images of hepatocellular carcinoma: correlation with histological grading and portal blood flow
Gd-EOB-DTPA-enhanced magnetic resonance images of hepatocellular carcinoma: correlation with histological grading and portal blood flow
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DOI：
10.1007/s00330-010-1812-9
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发表时间：
2010-10-01
影响因子：
5.9
通讯作者：
Murakami, Takamichi
中科院分区：
文献类型：
--
作者：
Kogita, Sachiyo;Imai, Yasuharu;Murakami, Takamichi
回顾性研究肝细胞癌（HCC）和异型增生结节（DN）在钆-乙氧苄基-二乙烯三胺（Gd-EOB-DTPA）增强MRI肝胆期的增强模式与组织学分级和门脉血流的关系。为了评估Gd-EOB-DTPA摄取，我们计算了EOB增强比，即肝胆相位图像上肿瘤病变与周围非肿瘤区域的相对强度（增强后EOB比）与未增强图像上的相对强度（增强前EOB比）的比值。在DN（1.00 ± 0.14）和高、中、低分化HCC（分别为0.79 ± 0.19，0.60 ± 0.27，0.49 ± 0.10）中，造影后EOB比值随分化程度的降低而显著降低。Gd-EOB-DTPA摄取，评估EOB增强比，略有下降，在DN和更多的HCC，而没有统计学差异，在不同的组织学分级的HCC之间的减少。在DN和高分化HCC中，门静脉血流量减少的发生率低于Gd-EOB-DTPA摄取减少的发生率，Gd-EOB-DTPA摄取减少可能是肝癌发生的早期事件，先于门静脉血流量减少。Gd-EOB-DTPA增强MRI的肝胆期可能有助于估计组织学分级，尽管在区分HCC和DN方面存在困难。
To retrospectively investigate enhancement patterns of hepatocellular carcinoma (HCC) and dysplastic nodule (DN) in the hepatobiliary phase of gadolinium-ethoxybenzyl-diethylenetriamine (Gd-EOB-DTPA)-enhanced MRI in relation to histological grading and portal blood flow.Sixty-nine consecutive patients with 83 histologically proven HCCs and DNs were studied. To assess Gd-EOB-DTPA uptake, we calculated the EOB enhancement ratio, which is the ratio of the relative intensity of tumorous lesion to surrounding nontumorous area on hepatobiliary phase images (post-contrast EOB ratio) to that on unenhanced images (pre-contrast EOB ratio). Portal blood flow was evaluated by CT during arterial portography.Post-contrast EOB ratios significantly decreased as the degree of differentiation declined in DNs (1.00 +/- 0.14) and well, moderately and poorly differentiated HCCs (0.79 +/- 0.19, 0.60 +/- 0.27, 0.49 +/- 0.10 respectively). Gd-EOB-DTPA uptake, assessed by EOB enhancement ratios, deceased slightly in DNs and still more in HCCs, while there was no statistical difference in the decrease between different histological grades of HCC. Reductions in portal blood flow were observed less frequently than decreases in Gd-EOB-DTPA uptake in DNs and well-differentiated HCCs.Reduced Gd-EOB-DTPA uptake might be an early event of hepatocarcinogenesis, preceding portal blood flow reduction. The hepatobiliary phase of Gd-EOB-DTPA-enhanced MRI may help estimate histological grading, although difficulties exist in differentiating HCCs from DNs.