钆塞酸二钠在肝细胞癌诊断中的价值

李若坤; 严福华; 李克

doi:10.3969/j.issn.1001-5256.2018.07.003

钆塞酸二钠在肝细胞癌诊断中的价值

DOI: 10.3969/j.issn.1001-5256.2018.07.003

1. 上海交通大学医学院附属瑞金医院放射科
2. 复旦大学附属华山医院放射科

详细信息

中图分类号: R735.7
计量
- 文章访问数: 2156
- HTML全文浏览量: 19
- PDF下载量: 383
- 被引次数: 0
出版历程
- 收稿日期: 2018-04-11
- 出版日期: 2018-07-20

Value of Gd-EOB-DPTA in the diagnosis of hepatocellular carcinoma

Department of Radiology, Ruijin Hospital, Shanghai Jiao Tong University School of Medicine

摘要

摘要: 钆塞酸二钠（Gd-EOB-DTPA）是一种具有双对比成像功能的肝胆特异性对比剂,既可以通过动态增强反映病灶血供信息,还可以通过肝胆特异期成像反映肝细胞膜分子受体表达变化。Gd-EOB-DTPA能够多维度反映肝硬化结节多步癌变信息,提高乏血供肝细胞癌（HCC）及小肝癌的检出率,显示高危肝硬化结节,已被多项国内外临床实践指南用于HCC的无创性诊断。就Gd-EOB-DTPA在HCC中的诊断价值作一论述。
- 癌,肝细胞 /
- 钆塞酸二钠 /
- 诊断
Abstract: Gd-EOB-DPTA is a hepatocyte-specific contrast agent with the function of double-contrast imaging. It can reflect the blood supply of lesions via dynamic enhancement imaging and show the change in the expression of molecular receptors on hepatocyte membrane via hepatobiliary phase imaging. Gd-EOB-DPTA can reflect the multistep process of hepatocarcinogenesis from multiple dimensions, improve detection of hypovascular hepatocellular carcinoma ( HCC) and small HCC, display cirrhotic nodules with high-risk malignant transformation, and therefore, it has been recommended as a noninvasive tool for HCC diagnosis in China and international HCC clinical practice guidelines. This article reviews the recent advances of Gd-EOB-DTPA in the diagnosis of HCC.
- carcinoma, hepatocellular /
- gadoxetic acid /
- diagnosis

HTML全文

参考文献(28)

[1]Abdominal Study Group, Chinese Society of Radiology, Chinese Medical Association.Expert consensus on clinical application of hepatobiliary-specific MRI contrast agent Gd-EOB-DTPA[J].J Clin Hepatol, 2016, 32 (12) :2236-2241. (in Chinese) 中华医学会放射学分会腹部学组.肝胆特异性MRI对比剂钆塞酸二钠临床应用专家共识[J].临床肝胆病杂志, 2016, 32 (12) :2236-2241.

[2]KITAO A, ZEN Y, MATSUI O, et al.Hepatocellular carcinoma:Signal intensity at gadoxetic acid-enhanced MR imaging—correlation with molecular transporters and histopathologic features[J].Radiology, 2010, 256 (3) :817-826.

[3]PARK HJ, CHOI BI, LEE ES, et al.How to differentiate borderline hepatic nodules in hepatocarcinogenesis:Emphasis on imaging diagnosis[J].Liver Cancer, 2017, 6 (3) :189-203.

[4]LEE MH, KIM SH, PARK MJ, et al.Gadoxetic acid-enhanced hepatobiliary phase MRI and high-b-value diffusion-weighted imaging to distinguish well-differentiated hepatocellular carcinomas from benign nodules in patients with chronic liver disease[J].AJR Am J Roentgenol, 2011, 197 (5) :w868-w875.

[5]NARITA M, HATANO E, ARIZONO S, et al.Expression of OATP1 B3 determines uptake of Gd-EOB-DTPA in hepatocellular carcinoma[J].J Gastroenterol, 2009, 44 (7) :793-798.

[6]KITAO A, MATSUI O, YONEDA N, et al.Hepatocellular carcinoma with beta-catenin mutation:Imaging and pathologic characteristics[J].Radiology, 2015, 275 (3) :708-717.

[7]CHOI JW, LEE JM, KIM SJ, et al.Hepatocellular carcinoma:Imaging patterns on gadoxetic acid-enhanced MR images and their value as an imaging biomarker[J].Radiology, 2013, 267 (3) :776-786.

[8]CHOI YS, RHEE H, CHOI JY, et al.Histological characteristics of small hepatocellular carcinomas showing atypical enhancement patterns on gadoxetic acid-enhanced MR imaging[J].J Magn Reson Imaging, 2013, 37 (6) :1384-1391.

[9]CRUITE I, TANG A, SIRLIN CB.Imaging-based diagnostic systems for hepatocellular carcinoma[J].AJR Am J Roentgenol, 2013, 201 (1) :41-55.

[10]RHEE H, KIM MJ, PARK YN, et al.Gadoxetic acid-enhanced MRI findings of early hepatocellular carcinoma as defined by new histologic criteria[J].J Magn Reson Imaging, 2012, 35 (2) :393-398.

[11]KOGITA S, IMAI Y, OKADA M, et al.Gd-EOB-DTPA-enhanced magnetic resonance images of hepatocellular carcinoma:Correlation with histological grading and portal blood flow[J].Eur Radiol, 2010, 20 (10) :2405-2413.

[12]FENG ZC, LIAO YJ, LIANG Q, et al.The diagnostic performance of hepatocyte-specific Gadoxetic acid disodium (Gd-EOB-DTPA) for detection of small hepatocellular carcinoma:A Meta-analysis[J].Chin J Magn Reson Imaging, 2018, 9 (1) :48-53. (in Chinese) 冯智超, 廖云杰, 梁琪, 等.肝胆特异性MRI对比剂Gd-EOB-DTPA诊断小肝癌价值的Meta分析[J].磁共振成像, 2018, 9 (1) :48-53.

[13]ZENG MS, YE HY, GUO L, et al.Gd-EOB-DTPA-enhanced magnetic resonance imaging for focal liver lesions in Chinese patients:A multicenter, open-label, phase III study[J].Hepatobiliary Pancreat Dis Int, 2013, 12 (6) :607-616.

[14]COSTA EA, CUNHA GM, SMORODINSKY E, et al.Diagnostic accuracy of preoperative gadoxetic acid-enhanced 3-T MR imaging for malignant liver lesions by using ex vivo MR imaging-matched pathologic findings as the reference standard[J].Radiology, 2015, 276 (3) :775-786.

[15]LEE DH, LEE JM, BAEK JH, et al.Diagnostic performance of gadoxetic acid-enhanced liver MR imaging in the detection of HCCs and allocation of transplant recipients on the basis of the Milan criteria and UNOS guidelines:Correlation with histopathologic findings[J].Radiology, 2015, 274 (1) :149-160.

[16]ICHIKAWA T, SAITO K, YOSHIOKA N, et al.Detection and characterization of focal liver lesions:A Japanese phase III, multicenter comparison between gadoxetic acid disodium-enhanced magnetic resonance imaging and contrast-enhanced computed tomography predominantly in patients with hepatocellular carcinoma and chronic liver disease[J].Invest Radiol, 2010, 45 (3) :133-141.

[17]CHOI SH, BYUN JH, KWON HJ, et al.The usefulness of gadoxetic acid-enhanced dynamic magnetic resonance imaging in hepatocellular carcinoma:Toward improved staging[J].Ann Surg Oncol, 2015, 22 (3) :819-825.

[18]SUH CH, KIM KW, PARK SH, et al.A cost-effectiveness analysis of the diagnostic strategies for differentiating focal nodular hyperplasia from hepatocellular adenoma[J].Eur Radiol, 2018, 28 (1) :214-225.

[19]DUNCAN JK, MA N, VREUGDENBURG TD, et al.Gadoxetic acid-enhanced MRI for the characterization of hepatocellular carcinoma:A systematic review and meta-analysis[J].J Magn Reson Imaging, 2017, 45 (1) :281-290.

[20]CHO YK, KIM JW, KIM MY, et al.Non-hypervascular hypointense nodules on hepatocyte phase gadoxetic acid-enhanced MR images:Transformation of MR hepatobiliary hypointense nodules into hypervascular hepatocellular carcinomas[J].Gut Liver, 2018, 12 (1) :79-85.

[21]ICHIKAWA S, ICHIKAWA T, MOTOSUGI U, et al.Presence of a hypovascular hepatic nodule showing hypointensity on hepatocytephase image is a risk factor for hypervascular hepatocellular carcinoma[J].J Magn Reson Imaging, 2014, 39 (2) :293-297.

[22]KOMATSU N, MOTOSUGI U, MAEKAWA S, et al.Hepatocellular carcinoma risk assessment using gadoxetic acid-enhanced hepatocyte phase magnetic resonance imaging[J].Hepatol Res, 2014, 44 (13) :1339-1346.

[23]OMATA M, CHENG AL, KOKUDO N, et al.Asia-Pacific clinical practice guidelines on the management of hepatocellular carcinoma:A 2017 update[J].Hepatol Int, 2017, 11 (4) :317-370.

[24]KUDO M, MATSUI O, IZUMI N, et al.JSH Consensus-based clinical practice guidelines for the management of hepatocellular carcinoma:2014 update by the Liver Cancer Study Group of Japan[J].Liver Cancer, 2014, 3 (3-4) :458-468.

[25]Korean Liver Cancer Study Group (KLCSG) , National Cancer Center.2014 Korean Liver Cancer Study Group-National Cancer Center Korea practice guideline for the management of hepatocellular carcinoma[J].Korean J Radiol, 2015, 16 (3) :465-522.

[26]TANG A, BASHIR MR, CORWIN MT, et al.Evidence supporting LI-RADS major features for CT-and MR imaging-based diagnosis of hepatocellular carcinoma:A systematic review[J].Radiology, 2018, 286 (1) :29-48.

[27]CHOI SH, BYUN JH, LIM YS, et al.Liver imaging reporting and data system:Patient outcomes for category 4 and 5 nodules[J].Radiology, 2018, 287 (2) :515-524.

[28]National Health and Family Planning Commission of the People's Republic of China.Diagnosis, management, and treatment of hepatocellular carcinoma (V2017) [J].J Clin Hepatol, 2017, 33 (8) :1419-1431. (in Chinese) 中华人民共和国国家卫生和计划生育委员会.原发性肝癌诊疗规范 (2017年版) [J].临床肝胆病杂志, 2017, 33 (8) :1419-1431.

施引文献

资源附件(0)

访问统计