对比剂对MRI非对称回波三点法水脂分离测量肝脏脂肪和铁的影响
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摘要
目的:探讨对比剂对非对称回波三点法水脂分离-定量测定(IDEAL-IQ)肝脏脂肪和铁定量的影响。方法:22例注射钆喷酸葡胺(Gd-DTPA,A组)和33例注射钆塞酸二纳(Gd-EOB-DTPA,B组)患者于注射前、后不同时间点(注射后5 min、10 min、15 min、20 min)行IDEAL-IQ扫描,在FatFrac图和R2~*图分别测定质子脂肪含量(PDFF)及R2~*值,并行组内配对t检验。结果:A1-A2配对分析,PDFF(t=0.996,P=0.330)及R2~*(t=0.656,P=0.519)的差异均无统计学意义;B1-B2、B1-B5配对分析,PDFF(t=-3.159、-2.459,P=0.003、0.024)及R2~*(t=-3.619、-3.191,P=0.001、0.005)的差异有统计学意义;B1-B3配对分析,PDFF的差异无统计学意义(t=-1.429,P=0.181),而R2~*的差异有统计学意义(t=-2.724,P=0.024)。结论:注射Gd-DTPA后5 min行IDEAL-IQ扫描,对肝脏脂肪及铁定量无显著影响;而注射Gd-EOB-DTPA后5 min及20 min行IDEAL-IQ扫描,对肝脏脂肪及铁定量有显著影响。
Objective:To explore the effect of contrast agents on the quantification of liver fat and iron using MRI IDEAL-IQ sequence.Methods:Twenty-two patients underwent MRI IDEAL-IQ scan before and after injection of gadolinium diethylenetriamine pentaacetic acid(Gd-DTPA)(group A) and 33 patients with gadolinium ethoxybenzyl dieathylenetriamine pentaacetic acid(Gd-EOB-DTPA)(group B) at different time points(15 min,10 min,15 min,20 min after injection).PDFF and R2~* were measured respectively on Fat Frac map and R2~* map,and in-group paired t test was performed.Results:There were not statistical difference found between the A1-A2 paired(PDFF:t=0.996,P=0.330;R2~*:t=0.656,P=0.519),but between the B1-B2 paired(PDFF:t=-3.159,P=0.003;R2~*:t=-3.619,P=0.001),B1-B5 paired(PDFF:t=-2.459,P=0.024;R2~*:t=-3.191,P=0.005),with the PDFF and the R2~*.The PDFF(t=-1.429,P=0.181) was not statistically different,while the R2~*(t=-2.724,P=0.024) was statistically significant between B1-B3 paired.Conclusion:Compared with pre-injection scan,Gd-DTPA has not significant effect on the quantification of hepatic fat and iron 5 min after injection.However,Gd-EOB-DTPA,has significant effect on the quantification of liver fat and iron at 5 min and 20 min after administration.
Objective:To explore the effect of contrast agents on the quantification of liver fat and iron using MRI IDEAL-IQ sequence.Methods:Twenty-two patients underwent MRI IDEAL-IQ scan before and after injection of gadolinium diethylenetriamine pentaacetic acid(Gd-DTPA)(group A) and 33 patients with gadolinium ethoxybenzyl dieathylenetriamine pentaacetic acid(Gd-EOB-DTPA)(group B) at different time points(15 min,10 min,15 min,20 min after injection).PDFF and R2~* were measured respectively on Fat Frac map and R2~* map,and in-group paired t test was performed.Results:There were not statistical difference found between the A1-A2 paired(PDFF:t=0.996,P=0.330;R2~*:t=0.656,P=0.519),but between the B1-B2 paired(PDFF:t=-3.159,P=0.003;R2~*:t=-3.619,P=0.001),B1-B5 paired(PDFF:t=-2.459,P=0.024;R2~*:t=-3.191,P=0.005),with the PDFF and the R2~*.The PDFF(t=-1.429,P=0.181) was not statistically different,while the R2~*(t=-2.724,P=0.024) was statistically significant between B1-B3 paired.Conclusion:Compared with pre-injection scan,Gd-DTPA has not significant effect on the quantification of hepatic fat and iron 5 min after injection.However,Gd-EOB-DTPA,has significant effect on the quantification of liver fat and iron at 5 min and 20 min after administration.
引文
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[9] 张静,潘晶晶,叶慧义.肝胆特异性对比剂钆塞酸二钠对肝、脾、肾ADC值的影响[J].中国医学影像学杂志,2014,22(7):508-510,514.
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[12] Liu X,Zhou L,Peng W,et al.Effect of intravenous gadolinium-DTPA on diffusion-weighted imaging for prostate lesions and normal tissue at 3.0-Tesla magnetic resonance imaging[J].Acta Radiol,2011,52(5):575-580.
[13] 冯飞,盘中贤,黄嵘,等.家兔肝脏3.0T磁共振扩散加权成像:钆塞酸二钠增强前后对比研究[J].中国CT和MRI杂志,2017,15(4):84-86.
[14] Yamada K,Kubota H,Kizu O,et al.Effect of intravenous gadolinium-DTPA on diffusion-weighted images:evaluation of normal brain and infarcts[J].Stroke,2002,33(7):1799-1802.
[15] Firat A K,Sanli B,Karakas HM,et al.The effect of intravenous gadolinium-DTPA on diffusion-weighted imaging[J].Neuroradiology,2006,48(7):465-470.
[16] 钱敏,刘晓航.MRI造影剂钆喷酸葡胺对弥散加权成像的影响[J].肿瘤影像学,2013,22(2):177-181.
[17] Hindman N,Ngo L,Genega EM,et al.Angiomyolipoma with minimal fat: can it be differentiated from clear cell renal cell carcinoma by using standard MR techniques[J].Radiology,2012,265(2):468-477.
[18] Shinohara YK,Kato A,Yamashita E,et al.R2* Map by IDEAL IQ for acute cerebral infarction:compared with susceptibility vessel sign on T2*-weighted imaging[J].Yonago Acta Medica,2016,59(3):204-209.
[19] Okada M,Ishii K,Numata K,et al.Can the biliary enhancement of Gd-EOB-DTPA predict the degree of liver fIlnction[J].Hepatobiliary Pancreat Dis Int,2012,11(3):307-313.
[20] 钟玉凤,唐作华.磁共振特异性对比剂在原发性肝癌诊断中的应用[J].放射学实践,2015,30(10):1056-1058.
[2] 郭若泪,唐文杰,朱叶青,等.磁共振IDEAL-IQ序列对肝脏脂肪变性和铁过载的诊断价值[J].中山大学学报(医学科学版),2015,36(5):689-692.
[3] Serai SD,Dillman JR,Trout AT.Proton density fat fraction measurements at 1.5T and 3.0T hepatic MR imaging:same-day agreement among readers and across two imager manufacturers[J].Radiology,2017,284(1):244-254.
[4] 吴小伟,陈自谦.磁共振IDEAL-IQ技术对肝脏脂肪定量的应用研究进展[J].功能与分子医学影像学(电子版),2017,6(1):1159-1162.
[5] 胡磊,查云飞,林苑,等.IDEAL-IQ定量评价兔糖尿病模型椎体骨髓脂肪含量的可行性研究[J].磁共振成像,2015,6(12):941-946.
[6] 李春燕,黄仲奎,龙莉玲,等.MRI测量R2值与铁浓度的相关性[J].实用放射学杂志,2015,(11):1872-1875.
[7] Liau J,Shiehmorteza M,Girard OM,et al.Evaluation of MRI fat fraction in the liver and spine pre and post SPIO infusion[J].Magn Reson Imaging,2013,31(6):1012-1016.
[8] 吴静云,王可,郭小超,等.肝脏MR动态增强扫描:Gd-EOB-DTPA与Gd-DTPA的个体内对照研究[J].放射学实践,2016,31(4):326-330.
[9] 张静,潘晶晶,叶慧义.肝胆特异性对比剂钆塞酸二钠对肝、脾、肾ADC值的影响[J].中国医学影像学杂志,2014,22(7):508-510,514.
[10] Hamm B,Staks T,Muhler A,et al.Phase I clinical evaluation of Gd-EOB-DTPA a hepatobiliary MR conctrast agent: safety,pharmacokinetics,and MR imaging[J].Radiology,1995,195(3):785-792.
[11] Choi JS,Kim MJ,Choi JY,et a1.Diffusion-weighted MR imaging of liver on 3.0-Tesla system: effect of intravenous administration of gadoxeticacid disodium[J].Eur Radiol,2010,20(5):1052-1060.
[12] Liu X,Zhou L,Peng W,et al.Effect of intravenous gadolinium-DTPA on diffusion-weighted imaging for prostate lesions and normal tissue at 3.0-Tesla magnetic resonance imaging[J].Acta Radiol,2011,52(5):575-580.
[13] 冯飞,盘中贤,黄嵘,等.家兔肝脏3.0T磁共振扩散加权成像:钆塞酸二钠增强前后对比研究[J].中国CT和MRI杂志,2017,15(4):84-86.
[14] Yamada K,Kubota H,Kizu O,et al.Effect of intravenous gadolinium-DTPA on diffusion-weighted images:evaluation of normal brain and infarcts[J].Stroke,2002,33(7):1799-1802.
[15] Firat A K,Sanli B,Karakas HM,et al.The effect of intravenous gadolinium-DTPA on diffusion-weighted imaging[J].Neuroradiology,2006,48(7):465-470.
[16] 钱敏,刘晓航.MRI造影剂钆喷酸葡胺对弥散加权成像的影响[J].肿瘤影像学,2013,22(2):177-181.
[17] Hindman N,Ngo L,Genega EM,et al.Angiomyolipoma with minimal fat: can it be differentiated from clear cell renal cell carcinoma by using standard MR techniques[J].Radiology,2012,265(2):468-477.
[18] Shinohara YK,Kato A,Yamashita E,et al.R2* Map by IDEAL IQ for acute cerebral infarction:compared with susceptibility vessel sign on T2*-weighted imaging[J].Yonago Acta Medica,2016,59(3):204-209.
[19] Okada M,Ishii K,Numata K,et al.Can the biliary enhancement of Gd-EOB-DTPA predict the degree of liver fIlnction[J].Hepatobiliary Pancreat Dis Int,2012,11(3):307-313.
[20] 钟玉凤,唐作华.磁共振特异性对比剂在原发性肝癌诊断中的应用[J].放射学实践,2015,30(10):1056-1058.