摘要
目的通过行肝脏多b值弥散加权成像（DWI），观察注射钆塞酸二钠（Gd—EOB—DTPA）前、后不同时相表观弥散系数（ADC）值的变化，探讨增强后行DWI的可行性。方法收集行Gd．EOB—DTPA肝脏增强的受检者126例，其中，例行体检的健康志愿者30名，肝脏病变患者96例（原发性肝癌25例、转移性肝癌20例、肝血管瘤28例、肝囊肿23例），均经临床或病理证实。在PhilipsAchieva1．5T双梯度超导MR成像系统上，行同相与正反相T1加权像闭气轴位平扫及轴位呼吸门控DWI。通过肘静脉向受检者注射0．025mmol／kgGd．EOB．DTPA，行动脉期、静脉期、3min期、10min期、20min期、30rain期闭气轴位T1加权高分辨率各向同性容积激发序列（THRIVE）扫描，在5rain期，行轴位T2加权像脂肪抑制呼吸门控扫描，在15min期，行轴位呼吸门控DWI后，接着行冠状位T2加权闭气扫描，在25min期，行轴位呼吸门控DWI。平扫期、15min期、25min期的DWI参数完全一致，为单次激发自旋回波．平面回波成像（SE—EPI）序列，b值依次取0、50、300、600s／mm2，扫描时间196S。在EWS工作站上，通过ADC分析函数生成平扫期、15min期、25min期在b=50、300、600s／ram。时的ADC图，测出正常肝脏、原发性肝癌、转移性肝癌、肝血管瘤、肝囊肿的ADC值，对同-b值下同一疾病在平扫期、15min期及25min期的ADC值进行t检验，分析是否存在统计学差异。结果同-b值下同一疾病的ADC值在平扫期时最大，随着Gd—EOB—DTPA的注入，ADC值开始下降，然后上升，到了25rain期，ADC值与平扫期时基本一致，15rain期的ADC值最低，平扫期、15rain期、25min期的ADC值差异无统计学意义（t=0．25～1．29，P均〉O．05）。同一疾病同一时相的DWI中，随着b值的增加，ADC值不断下降，b值越小，ADC值越大。结论静脉注射Gd—EOB—DTPA后，肝脏ADC值下降十分有限，增强后行DWI是可行的。
Objective To observe the variation of apparent diffusiou coefficient （ADC） and sum up the feasibility of diffusion weighted imaging （DWI） after enhancement by employing the multi-b value modelofliverDWI before and after injection of gadolinium-ethoxibenzyl-diethylene triaminepentaacetic acid （Gd-EOB-DTPA）. Methods Data from 126 patients with Gd-EOB-DTPA were collected. Among these patients, 30 had normal liver, 25 had liver cancer, 20 had metastatic carcinoma, 28 had hemangioma, and 23 had cysts, as confirmed by clinical and pathological examination. Philips Achieva 1.5T dual-gradient superconducting magnetic resonance scanner was used for in-phase, in-and-out phase T1 weighted breath hold axial scan, and axial respiratory gated DWI. 0.025 mmol/kg dose of Gd-EOB-DTPA was injected into the patients, temporal high resolution isotropic volume examination （THRIVE） and T1 weighted breathhold axial scan were conducted at arterial phase, venous phase and 3, 10, 20, and 30 min phases. Axial T2 weighted fat saturation respiratory gated scan was conducted at 5 min phase. Axial respiratory gated DWI was conducted at 15 min phase, followed by coronal T2 weighted breath hold scan. Axial respiratory gated DWI was conducted at 25 rain phase. The plain, 15 rain phase and 25 rain phase scan had the same DWI parameter which was single-excitation spin echo-echo planar imaging sequence, the b value was 0, 50, 300, 600 s/ram2, respectively, with a scan time of 196 s. The b=50, 300, and 600 s/mm2 ADC diagram of plain scan, 15 and 25 rain scan were generated on an EWS workstation by ADC analysis function. The ADC val- ues of normal liver, liver cancer, metastasis, hemangioma, and cyst were measured. At the same b values, the ADC values of the same type of disease were statistically analyzed by t test at plain scan, 15 and 25 min scan. Results For the same h value and disease, the ADC values of the plain scan were the largest. The ADC values began to decrease and finally increase with the injection of Gd-EOB-DTPA. These values at the 25 min scan were consistent with the result of the plain scan, and the 15 rain scan were the lowest. The ADC values had no significant difference in the plain scan, 15 min scan and 25 min scan（t=0.25-1.29, all P〉 0.05）. For the DWI of the same disease and phase, the b value increased and the ADC values decreased; the smaller the b value, the greater the ADC values. Conclusion After intravenous injection of Gd-EOB-DTPA, the decrease of the ADC values in the liver was minimal, and DWI was feasible after enhancement.
出处
《国际放射医学核医学杂志》
2017年第1期23-28,共6页
International Journal of Radiation Medicine and Nuclear Medicine
基金
江门市科技计划项目（江科[2013]81号-44）
关键词
磁共振成像
弥散
表观弥散系数
肝脏
钆塞酸二钠
Diffusion magnetic resonance imaging
Apparent diffusion coefficient
Liver
Gadolinium-ethoxibenzyl-diethylene triaminepentaacetic acid
