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1.
BMC Vet Res ; 15(1): 293, 2019 Aug 14.
Artigo em Inglês | MEDLINE | ID: mdl-31412920

RESUMO

BACKGROUND: Magnetic resonance imaging using gadoxetic acid, a hepatocyte-specific contrast agent, is one of the most useful MRI techniques used to diagnose liver tumours in humans. During the hepato-biliary phase, there is uptake of gadoxetic acid by normal hepatocytes, leading to hepatic parenchymal enhancement. This feature is used in human medicine to diagnose hepatic parenchymal metastatic disease, to differentiate primary liver tumours, to diagnose liver cirrhosis and focal nodular hyperplasia. This study presents the preliminary results of magnetic resonance imaging of focal lesions localised in the liver parenchyma in dogs following the administration of gadoxetic acid. RESULTS: The lesion enhancement ratio (ERlesion) in the tumour metastasis was 0.05; the liver enhancement ratio (ERliver) - 0.49 and the post-contrast lesion-to-liver contrast ratio (CR) was 0.17. In dogs with hepatocellular hyperplasia, these values were 0.54; 0.51; and 1.18, respectively. In two dogs with a hepatic adenoma, the ERlesion was 0.26 and 0.17, respectively; the ERliver was 0.47 and 0.47, respectively and the CR was 0.33 and 0.31, respectively. In the dog with a neuroendocrine tumour, the ERlesion was 0.03; the ERliver amounted to 0.58 and the CR was 0.35. In the case of a hepatocellular carcinoma, these coefficients were 0.2, 0.6 and 0.3, respectively. CONCLUSION: Based on the results, it may be assumed that the MR images of the proliferative hepatic parenchymal lesions in dogs using gadoxetic acid are similar to those obtained in humans. This suggests that the contrast enhancement patterns used in human medicine may be useful in differentiating hepatic parenchymal lesions in dogs.


Assuntos
Meios de Contraste/farmacologia , Doenças do Cão/diagnóstico por imagem , Gadolínio DTPA/farmacologia , Neoplasias Hepáticas/veterinária , Imagem por Ressonância Magnética/veterinária , Animais , Cães , Feminino , Neoplasias Hepáticas/diagnóstico por imagem , Masculino , Projetos Piloto
2.
Nanoscale ; 11(27): 12973-12982, 2019 Jul 21.
Artigo em Inglês | MEDLINE | ID: mdl-31263818

RESUMO

Nano-theranostic agents play important roles in the development of therapeutic methods for serious diseases. In this study, novel carbon dots (CDs) L-CD/C-CD were prepared from Gd(iii) salt/complexes, cationic polymers and citric acid in the hope that they would combine the abilities of gene delivery and multi-modal (MR/FL) imaging. The CDs inherited the properties of good water-solubility and positive charge from their precursor polymers. In vitro gene transfection results showed that the CDs have good transfection efficiency and anti-serum ability, especially for L-CD, which has 74 times higher transfection efficiency than PEI 25 kDa in the presence of 10% serum. The CDs exhibited bright fluorescence, which was stable for several days under various pH. Confocal laser scanning microscopy revealed that the CDs could image HeLa cells with blue or green fluorescence well, and realize the monitoring of the gene delivery process. Besides, the CDs showed favorable biocompatibility with excellent performance in longitudinal relaxivity rates (r1) of 11.4 mM-1 s-1 for L-CD and 57.6 mM-1 s-1 for C-CD, which were about 3-15 times higher than that of the clinical Gd reagent Gd-DTPA (3.75 mM-1 s-1). Furthermore, the CDs could perform in vivo tumor-specific MR-imaging more clearly than Gd-DTPA, which is attributed to their suitable particle size and their resulting greater accumulation at tumor site via the EPR effect. This study provides a promising strategy for constructing multi-functional CDs for tumor theranostics.


Assuntos
Carbono , Meios de Contraste , Gadolínio DTPA , Imagem Multimodal , Neoplasias Experimentais/diagnóstico por imagem , Pontos Quânticos/química , Animais , Carbono/química , Carbono/farmacologia , Meios de Contraste/química , Meios de Contraste/farmacologia , Feminino , Gadolínio/química , Gadolínio/farmacologia , Gadolínio DTPA/química , Gadolínio DTPA/farmacologia , Células HeLa , Humanos , Camundongos , Camundongos Endogâmicos BALB C , Microscopia Confocal , Neoplasias Experimentais/metabolismo , Neoplasias Experimentais/patologia , Nanomedicina Teranóstica
3.
BMC Gastroenterol ; 19(1): 129, 2019 Jul 24.
Artigo em Inglês | MEDLINE | ID: mdl-31340755

RESUMO

BACKGROUND: Imaging is an essential tool in the management of patients with Colorectal cancer (CRC) by helping evaluate number and sites of metastases, determine resectability, assess response to treatment, detect drug toxicities and recurrences. Although multidetector computed tomography (MDCT) is the first tool used for staging and patient's surveillance, magnetic resonance imaging (MRI) is the most reliable imaging modality that allows to assess liver metastases. Our purpose is to compare the diagnostic performance of gadoxetic acid-(Gd-EOB) enhanced liver MRI and contrast-enhanced MDCT in the detection of liver metastasis from colorectal cancer (mCRC). METHODS: One hundred and twenty-eight patients with pathologically proven mCRC (512 liver metastases) underwent Gd-EOB MRI and MDCT imaging. An additional 46 patients without mCRC were included as control subjects. Three radiologists independently graded the presence of liver nodules on a five-point confidence scale. Sensitivity and specificity for the detection of metastases were calculated. Weighted к values were used to evaluate inter-reader agreement of the confidence scale regarding the presence of the lesion. RESULTS: MRI detected 489 liver metastases and MDCT 384. In terms of per-lesion sensitivity in the detection of liver metastasis, all three readers had higher diagnostic sensitivity with Gd-EOB MRI than with MDCT (95.5% vs. 72% reader 1; 90% vs. 72% reader 2; 96% vs. 75% reader 3). Each reader showed a statistical significant difference (p < <.001 at Chi square test). MR imaging showed a higher performance than MDCT in per-patient detection sensitivity (100% vs. 74.2% [p < <.001] reader 1, 98% vs. 73% [p < <.001] reader 2, and 100% vs. 78% [p < <.001] reader 3). In the control group, MRI and MDCT showed similar per-patient specificity (100% vs. 98% [p = 0.31] reader 1, 100% vs. 100% [p = 0.92] reader 2, and 100% vs. 96% [p = 0.047] reader 3). Inter-reader agreement of lesion detection between the three radiologists was moderate to excellent (k range, 0.56-0.86) for Gd-EOB MRI and substantial to excellent for MDCT (k range, 0.75-0.8). CONCLUSION: Gadoxetic acid-enhanced MRI performs significantly better in the detection of mCRC, than MDCT, particularly in patients treated with chemotherapy, in subcapsular lesions, and in peribiliary metastases.


Assuntos
Neoplasias Colorretais/patologia , Gadolínio DTPA/farmacologia , Neoplasias Hepáticas , Fígado/diagnóstico por imagem , Metástase Neoplásica/diagnóstico por imagem , Meios de Contraste/farmacologia , Feminino , Humanos , Aumento da Imagem/métodos , Itália , Neoplasias Hepáticas/patologia , Neoplasias Hepáticas/secundário , Imagem por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Tomografia Computadorizada Multidetectores , Estadiamento de Neoplasias , Reprodutibilidade dos Testes , Estudos Retrospectivos
4.
Biomed Res Int ; 2019: 3901907, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31192255

RESUMO

Purpose: To evaluate gadolinium (Gd) retention and clearance in the brain of diabetic rats after administrations of gadodiamide, gadopentetate dimeglumine, and gadoterate meglumine. Materials and Methods: Both diabetic rats (n = 52) and normal rats (n = 52) intravenously received 20 injections of 0.6 mmol Gd/kg gadodiamide, gadopentetate dimeglumine, gadoterate meglumine, or saline. Both diabetic rats and normal rats were divided into 2 subgroups of 24 and 28 rats for the 7-day and 42-day evaluations (i.e., they were sacrificed at 7 days (n = 6 per group) and 42 days (n = 7 per group)), respectively, after the last injection. For the 7-day subgroup, 6 rats were euthanized for inductively coupled plasma mass spectrometry (ICP-MS) analysis. For the 42-day subgroup, 6 rats underwent T1-weighted magnetic resonance imaging (MRI) and ICP-MS, and 1 rat was analyzed by transmission electron microscopy (TEM). Results: The T1 enhancements in the deep cerebellar nuclei (DCNs) of diabetic rats were lower than those of normal rats in both linear Gd-based contrast agent (GBCA) groups (p < 0.05). The average Gd concentrations in the brains of diabetic rats were significantly lower than those of healthy rats in both the short-term groups and long-term groups (p < 0.05). The highest Gd retentions were in the olfactory bulb, DCN, and striatum with gadodiamide. Compared with the results obtained 7 days after the last injection, the residual Gd concentrations of the 42-day subgroups in the brains of diabetic rats showed no significant difference in both linear GBCA groups (p>0.05). Conclusions: Compared with normal rats, the diabetic status decreased the residual Gd concentrations in the brain after multiple administrations of gadodiamide, gadopentetate dimeglumine, and gadoterate meglumine. The clearable fraction of Gd in the brain was eliminated faster in diabetic rats than in normal rats.


Assuntos
Encéfalo , Diabetes Mellitus Experimental , Gadolínio DTPA , Imagem por Ressonância Magnética , Meglumina , Compostos Organometálicos , Animais , Encéfalo/diagnóstico por imagem , Encéfalo/metabolismo , Diabetes Mellitus Experimental/diagnóstico por imagem , Diabetes Mellitus Experimental/metabolismo , Gadolínio/farmacocinética , Gadolínio/farmacologia , Gadolínio DTPA/farmacocinética , Gadolínio DTPA/farmacologia , Masculino , Meglumina/farmacocinética , Meglumina/farmacologia , Compostos Organometálicos/farmacocinética , Compostos Organometálicos/farmacologia , Ratos , Ratos Wistar , Fatores de Tempo
5.
Magn Reson Imaging ; 61: 116-123, 2019 09.
Artigo em Inglês | MEDLINE | ID: mdl-31129279

RESUMO

BACKGROUND: To prospectively determine whether the use of a multiple arterial phase imaging (DISCO) improve the capturing rate of late arterial phase with less motion artifact than single arterial phase obtained with gadoxetate acid disodium. MATERIALS AND METHODS: From 06/2017 to 10/2018, prospectively acquired data of 132 patients who underwent either single (n = 67) or multiple arterial phase (n = 65) gadoxetate acid-enhanced MR imaging were analyzed. Two readers independently assessed arterial phase timing and the degree of motion artifact using a five-point scale. The kappa test was used to determine the agreement between the two readers, χ2 or fisher exact test were used for the categorical variables and Student t-test or Mann-Whitney U test were used for the comparison of the motion artifacts. RESULTS: Good to perfect inter-observer agreement was obtained for the arterial phase timing and degree of motion artifact (all kappa value >0.70). Optimal timing of arterial phase was observed in 95.4% (62/65) of multiple arterial phase compared with 73.1% (49/67) of single arterial phase (χ2 = 12.209, p < 0.001). Motion artifact score of the late arterial phase images measured using single arterial phase acquisition (3.22 ±â€¯0.68) was significantly higher than the multiple arterial phase (2.42 ±â€¯0.74) group (t = 5.921, p < 0.001). For the multiple arterial phase comparison, motion artifact score of the 2nd, 3rd and 4th phases were also significant reduced compared with 1st, 5th and 6th phases (all p < 0.05). CONCLUSION: The use of multiple arterial phase acquisition with gadoxetate acid disodium can improve the capturing rate of well-timed late arterial phase with less motion artifact.


Assuntos
Artérias/diagnóstico por imagem , Meios de Contraste/farmacologia , Gadolínio DTPA/farmacologia , Imagem por Ressonância Magnética , Adulto , Idoso , Artefatos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Movimento (Física) , Variações Dependentes do Observador , Estudos Prospectivos , Reprodutibilidade dos Testes , Tomografia Computadorizada por Raios X
6.
Chin Med Sci J ; 34(1): 24-32, 2019 Mar 30.
Artigo em Inglês | MEDLINE | ID: mdl-30961777

RESUMO

Objective To explore the ability of texture analysis of gadoxetic acid-enhanced magnetic resonance imaging (MRI) T1 mapping images, as well as T1-weighted (T1W), T2-weighted (T2W) and apparent diffusion coefficient (ADC) maps for distinguishing between varying degrees of hepatic fibrosis in an experimental rat model.Methods Liver fibrosis in rats was induced by carbon tetrachloride intraperitoneal injection for 4-12 weeks (n=30). In the control group (n=10) normal saline was applied. The MRI protocol contained T2W, diffusion weighted imaging, pre-and post-contrast image series of T1W and T1 mapping images. METAVIR score was used to grade liver fibrosis as normal (F0), mild fibrosis (F1-2), and advanced fibrosis (F3-4). Texture parameters including mean gray-level intensity (Mean), standard deviation (SD), Entropy, mean of positive pixels (MPP), Skewness, and Kurtosis were obtained. Nonparametric Mann-Whitney U test was used to compare the average value of each texture parameter in each sequence for assessing the difference between F0 and F≥1 as well as F0-2 and F3-4. Receiver operating characteristic (ROC) curves were obtained to assess the diagnosing accuracy of the parameters for differentiating no liver fibrosis from liver fibrosis and rats with liver fibrosis grading F0-2 from those with grading F3-4. The area under ROC curve (AUC) was calculated to evaluate the diagnostic efficiency of texture parameters.Results Finally, 20 rats completed MR T1 mapping image scan. The pathologic staging of these 20 rats was no fibrosis (F0, n=6), mild fibrosis (F1-2, n=5) and advanced fibrosis (F3-4, n=9). On pre-contrast T1 mapping image, Entropy was seen to be statistically significant higher in the F≥1 group than that in the F0 group at each spatial scaling factor (SSF) setting (P=0.015, 0.015, 0.015, 0.013, 0.015 and 0.018 respectively to SSF=0, 2, 3, 4, 5, 6), and Mean of the F≥1 rats was statistically significant higher than that of the F0 rats at SSF 4, 5, 6 (P=0.004, 0.006, and 0.013, respectively). Entropy and Mean showed a moderate diagnostic performance in most SSF settings of T1 mapping pre-contrast images for differentiation of normal liver from liver fibrosis.Conclusions Certain texture features of gadoxetic acid-enhanced MR images, especially the Entropy of non-contrast T1 mapping image, was found to be a useful biomarker for the diagnosis of liver fibrosis.


Assuntos
Meios de Contraste/farmacologia , Imagem de Difusão por Ressonância Magnética , Gadolínio DTPA/farmacologia , Cirrose Hepática/diagnóstico por imagem , Cirrose Hepática/fisiopatologia , Animais , Modelos Animais de Doenças , Masculino , Ratos , Ratos Sprague-Dawley
7.
Eur Radiol ; 29(12): 6600-6610, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31001679

RESUMO

OBJECTIVES: To examine inter- and intra-observer agreement for four simple hepatobiliary phase (HBP)-based scores on gadoxetic acid (GA)-enhanced MRI and their correlation with liver function in patients with mixed chronic liver disease (CLD). METHODS: This single-center, retrospective study included 287 patients (62% male, 38% female, mean age 53.5 ± 13.7 years) with mixed CLD (20.9% hepatitis C, 19.2% alcoholic liver disease, 8% hepatitis B) who underwent GA-enhanced MRI of the liver for clinical care between 2010 and 2015. Relative liver enhancement (RLE), contrast uptake index (CUI), hepatic uptake index (HUI), and liver-to-spleen contrast index (LSI) were calculated by two radiologists independently using unenhanced and GA-enhanced HPB (obtained 20 min after GA administration) images; 50 patients selected at random were reviewed twice by one reader to assess intra-observer reliability. Agreement was assessed by intraclass correlation coefficient (ICC). The albumin-bilirubin (ALBI) score, the model of end-stage liver disease (MELD), and the Child-Turcotte-Pugh (CTP) score were calculated as standards of reference for hepatic function. RESULTS: Intra-observer ICCs ranged from 0.814 (0.668-0.896) for CUI to 0.969 (0.945-0.983) for RLE. Inter-observer ICCs ranged from 0.777 (0.605-0.874) for HUI to 0.979 (0.963-0.988) for RLE. All HBP-based scores correlated significantly (all p < 0.001) with the ALBI, MELD, and CTP scores and were able to discriminate patients with a MELD score ≥ 15 versus ≤ 14, with area under the curve values ranging from 0.760 for RLE to 0.782 for HUI. CONCLUSION: GA-enhanced, MRI-derived, HBP-based parameters showed excellent inter- and intra-observer agreement. All HBP-based parameters correlated with clinical and laboratory scores of hepatic dysfunction, with no significant differences between each other. KEY POINTS: • Radiological parameters that quantify the hepatic uptake of gadoxetic acid are highly reproducible. • These parameters can be used interchangeably because they correlate with each other and with scores of hepatic dysfunction. • Assessment of these parameters may be helpful in monitoring disease progression.


Assuntos
Gadolínio DTPA/farmacologia , Hepatopatias/diagnóstico , Imagem por Ressonância Magnética/métodos , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Doença Crônica , Meios de Contraste/farmacologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Curva ROC , Reprodutibilidade dos Testes , Estudos Retrospectivos , Adulto Jovem
8.
Eur Radiol ; 29(7): 3574-3583, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-30993435

RESUMO

PURPOSE: We evaluated the detection rate and degree of motion artifact of the modified CAIPIRINHA-VIBE (mC-VIBE) without view-sharing and compare them with the CAIPIRINHA-Dixon-TWIST-VIBE (CDT-VIBE) with view-sharing on multi-arterial gadoxetic acid-enhanced liver MRI in the assessment of hepatocellular carcinoma (HCC). MATERIAL AND METHODS: We retrospectively identified 114 pathological-proven hepatic tumors in 114 patients with risk of HCC who underwent multi-arterial gadoxetic acid-enhanced MRI between June 2016 and June 2018. All patients underwent triple arterial phase imaging using the mC-VIBE without view-sharing (54 patients; 49 HCCs and 5 non-HCCs) or the CDT-VIBE with view-sharing (60 patients; 55 HCCs and 5 non-HCCs). We compared the detection rate of two sequences for HCC, with reference to LI-RADS.V.2017. We also compared the mean motion scores and proportions of transient severe motion (TSM) in two sequences. RESULT: For the examination using the mC-VIBE, the HCC-detection rate was significantly higher, compared with that using CDT-VIBE (93.9% [46/49] vs 80.0% [44/55], respectively; p = 0.047). For the examination with the mC-VIBE, mean motion scores were significantly lower compared with those of CDT-VIBE for all multi-arterial phases (1.21, 1.19, and 1.15 vs. 1.82, 1.85, and 1.84, respectively; p < 0.001 for all three comparisons). The proportion of TSM in the CDT-VIBE was significantly higher than that in the mC-VIBE (15.0% [9/60] vs 0.0% [0/54], respectively; p = 0.003). CONCLUSION: In multi-arterial phase gadoxetic acid-enhanced MRI, the mC-VIBE sequence without view-sharing has slightly higher HCC-detection rate and fewer motion artifacts compared with CDT-VIBE with view-sharing. KEY POINTS: • Multi-arterial phase using the mC-VIBE without view-sharing can overcome motion artifacts, resulting in providing optimal arterial phase imaging. • The HCC-detection rate is slightly higher with the mC-VIBE vs. CAIPIRINHA-Dixon-TWIST-VIBE with view-sharing (CDT-VIBE). • View-sharing of CDT-VIBE in the multi-arterial phase is associated with increased frequency of TSM.


Assuntos
Artefatos , Carcinoma Hepatocelular/diagnóstico , Gadolínio DTPA/farmacologia , Interpretação de Imagem Assistida por Computador/métodos , Neoplasias Hepáticas/diagnóstico , Fígado/patologia , Imagem por Ressonância Magnética/métodos , Meios de Contraste/farmacologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Reprodutibilidade dos Testes , Estudos Retrospectivos
9.
ACS Appl Mater Interfaces ; 11(20): 18153-18164, 2019 May 22.
Artigo em Inglês | MEDLINE | ID: mdl-30964631

RESUMO

There is an increasing need for gadolinium-free magnetic resonance imaging (MRI) contrast agents, particularly for patients suffering from chronic kidney disease. Using a cluster-nanocarrier combination, we have identified a novel approach to the design of biomedical nanomaterials and report here the criteria for the cluster and the nanocarrier and the advantages of this combination. We have investigated the relaxivity of the following manganese oxo clusters: the parent cluster Mn3(O2CCH3)6(Bpy)2 (1) where Bpy = 2,2'-bipyridine and three new analogs, Mn3(O2CC6H4CH═CH2)6(Bpy)2 (2), Mn3(O2CC(CH3)═CH2)6(Bpy)2 (3), and Mn3O(O2CCH3)6(Pyr)2 (4) where Pyr = pyridine. The parent cluster, Mn3(O2CCH3)6(Bpy)2 (1), had impressive relaxivity ( r1 = 6.9 mM-1 s-1, r2 = 125 mM-1 s-1) and was found to be the most amenable for the synthesis of cluster-nanocarrier nanobeads. Using the inverse miniemulsion polymerization technique (1) in combination with the hydrophilic monomer acrylamide, we synthesized nanobeads (∼125 nm diameter) with homogeneously dispersed clusters within the polyacrylamide matrix (termed Mn3Bpy-PAm). The nanobeads were surface-modified by co-polymerization with an amine-functionalized monomer. This enabled various postsynthetic modifications, for example, to attach a near-IR dye, Cyanine7, as well as a targeting agent. When evaluated as a potential multimodal MRI contrast agent, high relaxivity and contrast were observed with r1 = 54.4 mM-1 s-1 and r2 = 144 mM-1 s-1, surpassing T1 relaxivity of clinically used Gd-DTPA chelates as well as comparable T2 relaxivity to iron oxide microspheres. Physicochemical properties, cellular uptake, and impacts on cell viability were also investigated.


Assuntos
Resinas Acrílicas , Meios de Contraste , Gadolínio DTPA , Imagem por Ressonância Magnética , Imagem Multimodal , Nanopartículas , Neoplasias Experimentais/diagnóstico por imagem , Resinas Acrílicas/química , Resinas Acrílicas/farmacologia , Animais , Meios de Contraste/química , Meios de Contraste/farmacologia , Gadolínio DTPA/química , Gadolínio DTPA/farmacologia , Humanos , Manganês/química , Manganês/farmacologia , Camundongos , Camundongos Nus , Nanopartículas/química , Nanopartículas/uso terapêutico , Células PC-3
10.
Eur Radiol ; 29(11): 5861-5872, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-30899977

RESUMO

OBJECTIVES: Predicting post-hepatectomy liver failure (PHLF) after extended right hepatectomy following portal vein embolization (PVE) from serial gadoxetic acid-enhanced magnetic resonance imaging (MRI). METHODS: Thirty-six patients who underwent hepatectomy following PVE were evaluated prospectively with gadoxetic acid-enhanced MRI examinations at predefined intervals during the course of their treatment, i.e., before and 14 days and 28 days after PVE as well as 10 days after hepatectomy. Relative enhancement (RE) and volume of the left and right liver lobes were determined. The study population was divided into two groups with respect to signs of PHLF. Differences between the two groups were assessed using the Mann-Whitney U test, and predictive parameters for group membership were investigated using ROC and logistic regression analysis. RESULTS: RE of the left lobe prior to PVE versus 14 days after PVE was significantly lower in patients with PHLF than in those without PHLF (Mann-Whitney U test p < 0.001) and proved to be the best predictor of PHLF in ROC analysis with an AUC of 0.854 (p < 0.001) and a cutoff value of - 0.044 with 75.0% sensitivity and 92.6% specificity. Consistent with this result, logistic linear regression analysis adjusted for age identified the same parameter to be a significant predictor of PHLF (p = 0.040). CONCLUSIONS: Gadoxetic acid-enhanced MRI performed as an imaging-based liver function test before and after PVE can help to predict PHLF. The risk of PHLF can be predicted as early as 14 days after PVE. KEY POINTS: • To predict the likelihood of post-hepatectomy liver failure, it is important to estimate not only future liver remnant volume prior to extended liver resection but also future liver remnant function. • Future liver remnant function can be predicted by performing gadoxetic acid-enhanced MRI as an imaging-based liver function test before and after portal vein embolization. • A reduction of relative enhancement of the liver in gadoxetic acid-enhanced MRI after portal vein embolization of 0.044 predicts post-hepatectomy liver failure with 75.0% sensitivity and 92.6% specificity.


Assuntos
Embolização Terapêutica/efeitos adversos , Gadolínio DTPA/farmacologia , Hepatectomia/efeitos adversos , Falência Hepática/diagnóstico , Neoplasias Hepáticas/terapia , Imagem por Ressonância Magnética/métodos , Idoso , Feminino , Humanos , Falência Hepática/etiologia , Testes de Função Hepática , Neoplasias Hepáticas/diagnóstico , Masculino , Pessoa de Meia-Idade , Veia Porta , Curva ROC
11.
Eur Radiol ; 29(7): 3584-3594, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-30903328

RESUMO

OBJECTIVES: To compare look-locker inversion recovery (LLIR) and B1 inhomogeneity-corrected variable flip angle T1 mapping methods for estimation of liver function and prediction of hepatic insufficiency and decompensation on gadoxetic acid-enhanced MR imaging. METHODS: In this retrospective study, 248 patients with normal liver function, chronic liver disease, or cirrhosis underwent gadoxetic acid-enhanced liver MR imaging, including T1 mapping at 10-min and 20-min hepatobiliary phase (HBP) by using both methods. T1 relaxation times of the liver (T1Liver-pre, T1Liver-post) and the spleen (T1Spleen) were correlated between two methods. ΔT1Liver ([T1Liver-pre - T1Liver-post]/T1Liver-pre), adjusted T1Liver ([T1Spleen - T1Liver-post]/T1Spleen), and functional liver volume-to-weight ratio (liver volume on volumetric T1 map/[T1Liver-post × patient's weight]) were calculated. The diagnostic performance of T1 parameters and the predictive performance of models (serum marker, serum marker plus T1 parameter) were compared. RESULTS: T1Liver-post showed a strong correlation (r = 0.93, p < 0.001) between two methods but was significantly different. For depicting cirrhosis, LLIR-adjusted T1Liver at 10-min HBP showed the highest performance (p < 0.025). For predicting hepatic insufficiency and decompensation, LLIR-adjusted T1Liver (Akaike information criterion (AIC), 58.37; C-index, 0.867) and LLIR-T1Liver-post (AIC, 48.82; C-index, 0.885) at 10-min HBP showed the best performance, respectively, when added to serum albumin level. CONCLUSIONS: T1Liver-post showed a strong correlation between two methods but with significant differences. T1 mapping using LLIR at 10-min HBP with obtainment of adjusted T1Liver and T1Liver-post may be the best approach for estimation of liver function and prediction of hepatic insufficiency and decompensation. KEY POINTS: • T1 Liver-post showed a strong correlation between LLIR and B 1 inhomogeneity-corrected VFA methods, both at 10-min and 20-min HBP but with significant differences. • T1 Liver-post at 10-min and 20-min HBP using LLIR and B 1 inhomogeneity-corrected VFA methods could not be used interchangeably during the follow-up in patients with chronic liver disease (CLD) or cirrhosis. • T1 mapping using LLIR at 10-min HBP with obtainment of adjusted T1 Liver and T1 Liver-post may be the most suitable method and parameter for estimation of global liver function and prediction of clinical outcomes in patients with CLD or cirrhosis.


Assuntos
Gadolínio DTPA/farmacologia , Cirrose Hepática/diagnóstico , Testes de Função Hepática/métodos , Fígado/patologia , Imagem por Ressonância Magnética/métodos , Adulto , Idoso , Idoso de 80 Anos ou mais , Meios de Contraste/farmacologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos
12.
Eur Radiol ; 29(11): 5852-5860, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-30888485

RESUMO

OBJECTIVE: To assess the lesion detection performance of an abbreviated MRI (AMRI-M) protocol consisting of ultrafast SE T2W, DWI, and T1W-HBP at 20 min for colorectal liver metastasis (CRLM) surveillance. METHODS: In this Institutional Review Board (IRB)-approved retrospective study, gadoxetic acid-enhanced MRI scans of 57 patients (43 with pathologically proven CRLMs) were assessed. Two readers independently evaluated two sets of images per patient and commented on the number, location, and size of liver lesions. Set 1 included ultrafast spin-echo (SE) T2-weighted (T2W) + T1-weighted (T1W) hepatobiliary phase (HBP) at 20 min sequences + diffusion-weighted imaging (DWI), and set 2 consisted of the standard MRI protocol. A maximum of 10 lesions per patient were recorded. Cohen's kappa analysis, sensitivity, areas under the curve (AUCs), and the MRI cost analysis of the AMRI-M protocol were assessed. RESULTS: Between 198 and 209 lesions were assessed with each set of images. The inter-observer agreement for the abbreviated protocol was reported excellent (κ = 0.91). The sensitivity and AUCs for the lesion characterization of AMRI-M protocol were very high (over 90%) for both readers. No statistically significant differences in sensitivity (assessed by mixed-effects logistic regression) and AUCs for lesion characterization (by ROC regression) were found between both protocols. The AMRI-M acquisition time was estimated to be less than 10 min, which translated into 59% cost of standard MRI. CONCLUSION: Our proposed AMRI-M protocol (ultrafast SE T2W, DWI, and T1W-HBP at 20 min) is fast, low-cost alternative to the standard MRI protocol and has a high lesion detection performance. KEY POINTS: • Gadoxetic acid-enhanced protocol has increased the accuracy, sensitivity, and specificity of MRI for detecting colorectal liver metastases. • Our proposed abbreviated MRI protocol is fast, low-cost alternative compared with the standard MRI protocol and has a high lesion detection performance. • Adoption of our protocol may translate to substantial savings for patients and payers.


Assuntos
Neoplasias Colorretais/patologia , Gadolínio DTPA/farmacologia , Neoplasias Hepáticas/diagnóstico , Imagem por Ressonância Magnética/métodos , Estadiamento de Neoplasias/métodos , Meios de Contraste/farmacologia , Feminino , Humanos , Neoplasias Hepáticas/secundário , Masculino , Pessoa de Meia-Idade , Metástase Neoplásica , Curva ROC , Reprodutibilidade dos Testes , Estudos Retrospectivos
13.
Eur Radiol ; 29(10): 5205-5216, 2019 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-30915560

RESUMO

OBJECTIVES: To determine the sensitivity and positive predictive value (PPV) of gadobenate-enhanced MR imaging for the detection of liver metastases. METHODS: This systematic review and meta-analysis was conducted according to PRISMA guidelines. A comprehensive search (EMBASE, PubMed) was performed to identify relevant articles up to December 2017. Studies eligible for inclusion were performed using appropriate methodology with complete verification by means of histopathology, intraoperative observation and/or follow-up, and sufficient information to permit determination of true-positive (TP), false-negative (FN), and false-positive (FP) values. Sources of bias were assessed using the QUADAS-2 tool. An inverse variance-weighted random-effects model was used to obtain sensitivity and PPV estimates. Information was analyzed and presented using Cochran's Q statistic, funnel plots, and modified Deeks' analysis. RESULTS: Ten articles (256 patients, 562 metastases) were included. Sensitivity estimates for pre-contrast (unenhanced) imaging, gadobenate-enhanced dynamic imaging, and combined unenhanced, dynamic, and delayed hepatobiliary phase imaging for detecting liver metastases on a per-lesion basis were 77.8% (95% CI 71.4-84.3%, 7 assessments), 88.1% (95% CI, 84.0-92.2%, 13 assessments), and 95.1% (95% CI 93.1-97.1%, 15 assessments), respectively. The addition of hepatobiliary phase images significantly improved the detection of liver metastases. The overall PPV was 90.9% (95% CI 86.6-95.1%, 11 assessments). Deeks' funnel analysis revealed no association between sample size and sensitivity (ß = 0.02, p = 0.814) indicating no significant publication bias. CONCLUSIONS: Gadobenate-enhanced MR imaging has high sensitivity and PPV for the detection of liver metastases on a per-lesion basis. The sensitivity and PPV for detection is comparable to reported values for the pure liver-specific agent gadoxetate. KEY POINTS: • Gadobenate dimeglumine is a hepatobiliary MR contrast agent that permits acquisition of contrast-enhanced liver images during the immediate post-injection dynamic phase, like any extracellular agent, and in the delayed hepatobiliary phase, after specific uptake by the hepatocytes. • The hepatobiliary phase improves detection of liver metastases when compared either to pre-contrast unenhanced images alone or to pre-contrast + gadobenate-enhanced dynamic phase images. • The meta-analysis showed an overall sensitivity of 95.1% and PPV of 90.9% of gadobenate-enhanced MRI for the detection of metastases, when based on the evaluation of all available acquisitions.


Assuntos
Gadolínio DTPA/farmacologia , Neoplasias Hepáticas/diagnóstico , Fígado/patologia , Imagem por Ressonância Magnética/métodos , Adulto , Meios de Contraste/farmacologia , Feminino , Humanos , Aumento da Imagem/métodos , Neoplasias Hepáticas/secundário , Masculino , Pessoa de Meia-Idade , Sensibilidade e Especificidade
14.
Eur Radiol ; 29(9): 5063-5072, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-30796575

RESUMO

OBJECTIVES: To compare Gd-EOB-DTPA dynamic hepatocyte-specific contrast-enhanced MRI (DHCE-MRI) with 99mTc-mebrofenin hepatobiliary scintigraphy (HBS) as quantitative liver function tests for the preoperative assessment of patients undergoing liver resection. METHODS: Patients undergoing liver surgery and preoperative assessment of future remnant liver (FRL) function using 99mTc-mebrofenin HBS were included. Patients underwent DHCE-MRI. Total liver uptake function was calculated for both modalities: mebrofenin uptake rate (MUR) and Ki respectively. The FRL was delineated with both SPECT-CT and MRI to calculate the functional share. Blood samples were taken to assess biochemical liver parameters. RESULTS: A total of 20 patients were included. The HBS-derived MUR and the DHCE-MRI-derived mean Ki correlated strongly for both total and FRL function (Pearson r = 0.70, p = 0.001 and r = 0.89, p < 0.001 respectively). There was a strong agreement between the functional share determined with both modalities (ICC = 0.944, 95% CI 0.863-0.978, n = 20). There was a significant negative correlation between liver aminotransferases and bilirubin for both MUR and Ki. CONCLUSIONS: Assessment of liver function with DHCE-MRI is comparable with that of 99mTc-mebrofenin HBS and has the potential to be combined with diagnostic MRI imaging. This can therefore provide a one-stop-shop modality for the preoperative assessment of patients undergoing liver surgery. KEY POINTS: • Quantitative assessment of liver function using hepatobiliary scintigraphy is performed in the preoperative assessment of patients undergoing liver surgery in order to prevent posthepatectomy liver failure. • Gd-EOB-DTPA dynamic hepatocyte-specific contrast-enhanced MRI (DHCE-MRI) is an emerging method to quantify liver function and can serve as a potential alternative to hepatobiliary scintigraphy. • Assessment of liver function with dynamic gadoxetate-enhanced MRI is comparable with that of hepatobiliary scintigraphy and has the potential to be combined with diagnostic MRI imaging.


Assuntos
Gadolínio DTPA/farmacologia , Hepatopatias/diagnóstico , Fígado/diagnóstico por imagem , Cintilografia/métodos , Tomografia Computadorizada de Emissão de Fóton Único/métodos , Idoso , Feminino , Hepatectomia , Humanos , Hepatopatias/cirurgia , Testes de Função Hepática/métodos , Imagem por Ressonância Magnética/métodos , Masculino , Pessoa de Meia-Idade , Projetos Piloto , Estudos Prospectivos , Compostos Radiofarmacêuticos/farmacologia
15.
Korean J Radiol ; 20(1): 134-147, 2019 01.
Artigo em Inglês | MEDLINE | ID: mdl-30627029

RESUMO

Gadolinium-based contrast agents (GBCAs) are commonly used for enhancement in MR imaging and have long been considered safe when administered at recommended doses. However, since the report that nephrogenic systemic fibrosis is linked to the use of GBCAs in subjects with severe renal diseases, accumulating evidence has suggested that GBCAs are not cleared entirely from our bodies; some GBCAs are deposited in our tissues, including the brain. GBCA deposition in the brain is mostly linked to the specific chelate structure of the GBCA: linear GBCAs were responsible for brain deposition in almost all reported studies. This review aimed to summarize the current knowledge about GBCA brain deposition and discuss its clinical implications.


Assuntos
Encéfalo/diagnóstico por imagem , Meios de Contraste/análise , Gadolínio DTPA/análise , Gadolínio/análise , Imagem por Ressonância Magnética/métodos , Meios de Contraste/efeitos adversos , Meios de Contraste/farmacologia , Gadolínio/farmacologia , Gadolínio DTPA/efeitos adversos , Gadolínio DTPA/farmacologia , Humanos
16.
Eur Radiol ; 29(1): 401-410, 2019 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-29922928

RESUMO

OBJECTIVES: To use Liver Imaging Reporting and Data System (LI-RADS) categorization and features of hepatocellular carcinomas (HCCs) to intraindividually compare gadopentetate dimeglumine-enhanced magnetic resonance imaging (Gd-DTPA-MRI) and gadoxetic acid-enhanced MRI (Gd-EOB-MRI), before and after applying modified major features. METHODS: Of 77 HCCs in 64 patients analysed, 17 HCCs were confirmed histopathologically and 46 patients had cirrhosis. Gd-EOB-MRI and Gd-DTPA-MRI were evaluated for the presence of major and ancillary features by two radiologists. LI-RADS categorization was done for Gd-DTPA-MRI (LI-RADS-DTPA) and for Gd-EOB-MRI before and after applying modified major features (hepatobiliary phase [HBP] hypointensity as an additional major feature, LI-RADS-EOBm1; HBP hypointense rim as capsule appearance, LI-RADS-EOBm2; and transitional phase [TP] hypointensity as washout appearance, LI-RADS-EOBm3). Sensitivities of LR-5 categorization for the diagnosis of HCC were compared. RESULTS: Washout (p=0.012) and capsule appearance (p<0.001) were less frequently observed on Gd-EOB-MRI. Sensitivity for LR-5 categorization was significantly higher with LI-RADS-DTPA compared with LI-RADS-EOB (p=0.001) and LI-RADS-EOBm2 (p=0.004), while sensitivity for LR-5 categorization with LI-RADS-EOBm1 (p=0.210) and LI-RADS-EOBm3 (p=0.727) was comparable. CONCLUSION: Modifying LI-RADS for use with Gd-EOB-MRI, such as applying HBP hypointensity as an additional major feature or using TP hypointensity as washout appearance, can improve the sensitivity for the detection of HCC. KEY POINTS: • Adding HBP hypointensity as additional major feature improved sensitivity of LR-5 categorization. • Adding TP hypointensity as modified washout appearance improved sensitivity of LR-5 categorization. • Sensitivities for LR-5 classification were comparable between LI-RADS-DTPA, LI-RADS-EOBm1, and LI-RADS-EOBm3.


Assuntos
Carcinoma Hepatocelular/diagnóstico , Gadolínio DTPA/farmacologia , Neoplasias Hepáticas/diagnóstico , Imagem por Ressonância Magnética/métodos , Adulto , Idoso , Meios de Contraste/farmacologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Reprodutibilidade dos Testes
17.
Eur Radiol ; 29(2): 1032-1038, 2019 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-29992388

RESUMO

OBJECTIVES: To determine whether tumour enhancement on preoperative delayed-phase gadoxetate-enhanced MRI can predict long-term survival in patients with colorectal liver metastases (CRCLM) post-hepatectomy. MATERIALS AND METHODS: Sixty-five patients who received a preoperative gadoxetate-enhanced MRI prior to liver resection for CRCLM from January 1, 2010, to December 31, 2012, were included in this retrospective study. Target tumour enhancement (TuEn) was calculated as the mean percentage increase in SNR from precontrast to 10-min or 20-min delayed phase for up to two target lesions. Per-patient TuEn was stratified into weak and strong enhancement based on the cut-off determined by the Youden Index for 3-year survival. Kaplan-Meier and Cox regression analyses were used to determine whether tumour enhancement could predict overall survival independent of potential confounders (clinical risk score). RESULTS: The proportion surviving at 3 years was 85.1% in patients with strong TuEn at 10 min vs. 56.5% in those with weak TuEn at 10 min (p = 0.001). The proportion surviving at 3 years was 79.4% in patients with strong TuEn at 20 min vs. 58.7% in those with weak TuEn at 20 min (p = 0.011). After adjusting for potential confounders, the hazard ratio of death was 0.24 (p = 0.009) in patients who had weak TuEn at 10 min and 0.32 (p = 0.018) in patients who had weak TuEn at 20 min. CONCLUSIONS: Strong delayed tumour enhancement seen on gadoxetate-enhanced MRI is associated with overall survival in patients with CRCLM post-hepatectomy and may be useful for preoperative risk stratification. KEY POINTS: • Delayed tumour enhancement of colorectal liver metastases on gadoxetate-enhanced MRI is associated with survival post-hepatectomy • Delayed tumour enhancement of colorectal liver metastases on gadoxetate-enhanced MRI can be measured at both 10 min and 20 min post-contrast injection.


Assuntos
Neoplasias Colorretais/patologia , Gadolínio DTPA/farmacologia , Neoplasias Hepáticas/secundário , Imagem por Ressonância Magnética/métodos , Adulto , Idoso , Neoplasias Colorretais/mortalidade , Meios de Contraste/farmacologia , Feminino , Humanos , Neoplasias Hepáticas/diagnóstico , Neoplasias Hepáticas/mortalidade , Masculino , Pessoa de Meia-Idade , Ontário/epidemiologia , Estudos Retrospectivos , Fatores de Tempo
18.
Eur Radiol ; 29(1): 373-382, 2019 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-29955948

RESUMO

OBJECTIVES: To investigate the performance of the Liver Imaging Reporting and Data System (LI-RADS) v2017 for combined hepatocellular cholangiocarcinoma (cHCC-CCA) in the differential diagnosis from hepatocellular carcinoma (HCC) and prediction of prognosis on gadoxetic acid-enhanced MRI (Gd-EOB-MRI). METHODS: Patients at high risk of HCC with pathologically confirmed cHCC-CCAs (n = 70) and a matched control of HCCs (n = 70) who had undergone Gd-EOB-MRI were included. LI-RADS category was assigned for each lesion by two radiologists. Imaging features and surgical outcomes were compared between cHCC-CCAs of LR-M and LR-5/4 using the χ2 test or Fisher's exact test. Recurrence-free survival (RFS) was estimated using Kaplan-Meier survival curves and compared using the log-rank test. RESULTS: cHCC-CCAs and HCCs were categorised as LR-M, LR-5/4 and LR-TIV in 61.4% (43/70), 37.1% (26/70) and 1.4% (1/70) and 10.0% (7/70), 88.6% (62/70) and 1.4% (1/70), respectively. cHCC-CCAs of LR-5/4, in comparison to LR-M, showed significantly higher frequencies of major HCC features: arterial hyperenhancement (96.2% (25/26) vs. 58.1% (25/43), p = 0.001), washout appearance (80.8% (21/26) vs. 48.8% (21/43), p = 0.011) and enhancing capsule (34.6% (9/26) vs. 11.6% (5/43), p = 0.031). After curative surgery, patients with cHCC-CCAs of LR-M showed a higher early recurrence rate (≤ 6 months) than did those with LR-5/4 (27.8% (10/36) vs. 4.8% (1/21), p = 0.041), whereas no significant difference was observed in RFS (log-rank p = 0.084). CONCLUSIONS: By using LI-RADS on Gd-EOB-MRI, a substantial proportion of cHCC-CCAs can be categorised as non-LR-M. In addition, cHCC-CCAs mimicking HCCs on imaging (LR-5/4) may indicate better surgical outcomes with regard to early recurrence than those of LR-M. KEY POINTS: • cHCC-CCAs can be categorised as either LR-M or non-LR-M on Gd-EOB-MRI. • cHCC-CCAs of LR-5/4 frequently demonstrate major HCC imaging features. • LI-RADS categorisation may provide prognostic information after surgery in cHCC-CCAs.


Assuntos
Carcinoma Hepatocelular/diagnóstico , Gadolínio DTPA/farmacologia , Neoplasias Hepáticas/diagnóstico , Imagem por Ressonância Magnética/métodos , Meios de Contraste/farmacologia , Diagnóstico Diferencial , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Prognóstico
19.
Basic Clin Pharmacol Toxicol ; 124(2): 181-189, 2019 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-30120906

RESUMO

In the literature, there have been no studies showing clear results on how radio-contrast pharmaceuticals would affect intact disc tissue cells. In this context, it was aimed to evaluate the effects of iopromide and gadoxetic acid, frequently used in the discography, on intact lumbar disc tissue in pharmaco-molecular and histopathological level. Primary cell cultures were prepared from the healthy disc tissue of the patients operated in the neurosurgery clinic. Except for the control group, the cultures were incubated with the indicated radio-contrast agents. Cell viability, toxicity and proliferation indices were tested at specific time intervals. The cell viability was quantitatively analysed. It was also visually rechecked under a fluorescence microscope with acridine orange/propidium iodide staining. Simultaneously, cell surface morphology was analysed with an inverted light microscope, while haematoxylin and eosin (H&E) staining methodology was used in the histopathological evaluations. The obtained data were evaluated statistically. Unlike the literature, iopromide or gadoxetic acid did not have any adverse effects on the cell viability, proliferation and toxicity (P < 0.05). Although this study reveals that radio-contrast pharmaceuticals used in the discography, often used in neurosurgical practice, can be safely used, it should be remembered that this study was performed in an in vitro environment.


Assuntos
Meios de Contraste/toxicidade , Gadolínio DTPA/toxicidade , Disco Intervertebral/efeitos dos fármacos , Iohexol/análogos & derivados , Adulto , Sobrevivência Celular/efeitos dos fármacos , Meios de Contraste/farmacologia , Gadolínio DTPA/farmacologia , Humanos , Disco Intervertebral/diagnóstico por imagem , Disco Intervertebral/patologia , Degeneração do Disco Intervertebral/induzido quimicamente , Degeneração do Disco Intervertebral/diagnóstico por imagem , Degeneração do Disco Intervertebral/patologia , Iohexol/farmacologia , Iohexol/toxicidade , Dor Lombar/induzido quimicamente , Dor Lombar/patologia , Vértebras Lombares/efeitos dos fármacos , Vértebras Lombares/patologia , Cultura Primária de Células
20.
Eur Radiol ; 29(4): 2009-2016, 2019 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-30255255

RESUMO

OBJECTIVES: To evaluate the effect of a spiral tube on contrast enhancement in the hepatic arterial phase (HAP) of gadoxetic acid (Gd-EOB-DTPA)-enhanced magnetic resonance imaging (MRI). METHODS: In this retrospective study, we observed 104 patients who underwent dynamic MRI of the liver between October 2017 and December 2017. Three Gd-EOB-DTPA injection protocols were compared: (A) conventional method (undiluted Gd-EOB-DTPA, injection rate 1 ml/s, n = 36); (B) spiral dilution method (1:1 diluted Gd-EOB-DTPA with saline [off-label], injection rate 2 ml/s via spiral tube, n = 38); (C) spiral-flushed method (undiluted Gd-EOB-DTPA, injection rate 1 ml/s via spiral tube, n = 30). We regarded protocol-A as a control. The signal-to-noise ratio (SNR) of the abdominal aorta was calculated using arterial phase images. Image contrast and artefacts were evaluated by two board-certified radiologists, using a four-point scale. Statistical analyses included Dunnett's test, the Kruskal-Wallis test and the Steel test. RESULTS: The SNR of the aorta was significantly higher with protocol-C (25.4 ± 8.8) than protocol-A (20.8 ± 5.4, p = 0.01). There was no significant difference in SNR between protocols A and B (p = 0.47). The contrast score of protocol-C was significantly higher than that of protocol-A (p = 0.0019). There was no significant difference in contrast score between protocols A and B (p = 0.50). There was no significant difference in artefacts among the three protocols (p = 0.96). CONCLUSIONS: Use of a spiral tube with a slow injection protocol contributed to improved aortic contrast enhancement in the HAP of GD-EOB-DTPA-enhanced hepatic MRI. KEY POINTS: • Gadoxetic acid shows weaker arterial enhancement at recommended doses, compared with nonspecific gadolinium agents; selection of an appropriate injection protocol is important. • A spiral flow-generating tube improves the transport efficiency of the contrast media, and increases the signal-to-noise ratio of the aorta in hepatic arterial phase. • A spiral flow-generating tube does not contribute to artefact reduction in hepatic arterial phase.


Assuntos
Aorta Abdominal/diagnóstico por imagem , Gadolínio DTPA/farmacologia , Imagem Tridimensional , Hepatopatias/diagnóstico , Imagem por Ressonância Magnética/métodos , Adulto , Idoso , Idoso de 80 Anos ou mais , Artefatos , Meios de Contraste/farmacologia , Feminino , Artéria Hepática/patologia , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Solução Salina/farmacologia
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