Gd-EOB-DTPA与Gd-DTPA 增强 MR 对肝硬化患者肝血管和肝实质增强效果的自身对照研究

摘要

Objective:To evaluate the differences of enhance effects of common hepatic artery (CHA),portal vein (PV)and hepatic parenchyma on dynamic contrast-enhanced (DCE)MRI by using gadolinium ethoxybenzyldiethylenetri-amine pentaacetic acid (Gd-EOB-DTPA)and gadolinium diethylenetriamine pentaacetic acid (Gd-DTPA)separately in the same cirrhotic patient.Methods:The enhanced MR images of liver in 35 cirrhotic patients obtained by using Gd-EOB-DTPA and Gd-DTPA separately in the same patient were reviewed.The percentage enhancement (PE)of CHA,PV and hepatic parenchyma and the relative contrast (RC)between CHA,PV and hepatic parenchyma were calculated and analyzed statisti-cally.Results:The mean PEs of CHA,PV were significantly lower for Gd-EOB-DTPA than Gd-DPTA (P<0.05).The mean PE of hepatic parenchyma at portal phase using Gd-EOB-DTPA was markedly lower than that using Gd-DPTA (P<0.05),whereas there was no significant difference of the mean PE of hepatic parenchyma at arterial phase (P= 0.1010). The RC values of CHA,PV and hepatic parenchyma using Gd-DTPA was slightly higher than that using Gd-EOB-DTPA, yet with no significant statistic difference (P= 0.3421 and 0.2389 respectively).Conclusion:Compared with Gd-DTPA,the enhance effect of Gd-EOB-GTPA was lower in hepatic vessels and hepatic parenchyma in patients with cirrhosis,adjustment of the dosage of Gd-EOB-GTPA should be considered.%目的：自身对照比较Gd-EOB-DTPA 与Gd-DTPA 增强 MR 对肝硬化患者的肝动脉、门静脉和肝实质强化效果的差异。方法：回顾性分析35例肝硬化患者的Gd-EOB-DTPA与Gd-DTPA增强MR图像，计算肝总动脉、门静脉和肝实质的强化比率（PE）和肝总动脉、门静脉与肝实质的相对对比度（RC），并统计是否存在差异。结果：Gd-EOB-DTPA增强 MR肝总动脉、门静脉的平均PE明显低于Gd-DTPA（P＜0．05）。Gd-EOB-DTPA 的门脉期肝实质的平均PE 明显低于Gd-DTPA（P＜0．05）而动脉期肝实质的PE 值无明显差异（P＝0．1010）。肝总动脉、门静脉与肝实质的 RC 值 Gd-DTPA增强 MR略高于Gd-EOB-DTPA，但是无明显统计学差异（P 分别为0．3421和0．2389）。结论：肝硬化患者 Gd-EOB-DTPA增强 MR的肝血管和肝实质效果低于Gd-DTPA，Gd-EOB-DTPA的剂量需要进一步调整。