PDF(Pubmed)
Abstract：
There are many types of focal liver lesions (FLL) presenting different lesion signs and their diagnosis and differential diagnosis are relatively difficult. It is of great clinical significance to accurately detect, classify and characterize focal liver lesions as soon as possible. Diffusion-weighted imaging (DWI) provides information on liver cell density, microstructure, and microcirculation perfusion. Gadolinium-ethoxibenzyl-diethylenetriamine pentaacetic acid (Gd-EOB-DTPA) is a hepatobiliary-specific contrast agent. Gd-EOB-DTPA-enhanced MRI examination of liver provides information on the blood perfusion of lesions and specific information on the uptake function of normal liver cells. The combined application of the two can significantly improve the sensitivity and diagnostic accuracy in the detection of FLL. Herein, we reviewed the research findings on the application of DWI and Gd-EOB-DTPA in FLL diagnosis in order to provide reference for further clinical application. Most of the existing studies only made comparison and discussion of the DWI image quality of different b values and their fitted apparent diffusion coefficient (ADC) values before and after Gd-EOB-DTPA enhancement, and the reported findings are not only varied, but also inconsistent. Whether Gd-EOB-DTPA will affect DWI images is still been debated. Future research should focus on quantitative comparison, discussion and verification of the enhancement effect after injection of Gd-EOB-DTPA, as well as the changes in the ADC value corresponding to different b values before and after enhancement, in order to provide more objective and consistent research results for clinical application.
摘要：
肝脏局灶性病变（FLL）有多种类型，表现出不同的病变征象，其诊断和鉴别诊断相对困难。准确检测,具有重要的临床意义,尽快对肝脏局灶性病变进行分类和表征。扩散加权成像（DWI）提供肝细胞密度的信息，微观结构，和微循环灌注。钆-乙氧基苄基-二亚乙基三胺五乙酸(Gd-EOB-DTPA)是一种肝胆特异性造影剂。Gd-EOB-DTPA增强的肝脏MRI检查提供了有关病变血液灌注的信息以及有关正常肝细胞摄取功能的特定信息。二者联合应用可显著进步FLL检测的敏锐度和诊断精确性。在这里，本文就DWI和Gd-EOB-DTPA在FLL诊断中的应用研究进展作一综述，以期为进一步的临床应用提供参考。现有研究大多仅对Gd-EOB-DTPA增强前后不同b值的DWI图像质量及其拟合表观扩散系数(ADC)值进行了比较和讨论,报告的发现不仅多种多样，但也不一致。Gd-EOB-DTPA是否会影响DWI图像仍然存在争议。未来的研究应侧重于定量比较，对注射Gd-EOB-DTPA后的增强效果进行了讨论和验证，以及增强前后不同b值对应的ADC值的变化，为临床应用提供更客观、一致的研究结果。
