摘要： 目的 采用大鼠急性不均匀肝损伤动物模型，对比肝脏特异性造影剂钆塞酸二钠（Gd-EOB-DTPA）和细胞外造影剂钆喷替酸葡甲胺（Gd-DTPA）增强磁共振（MR）检测肝损伤的应用价值。方法 将24只雄性大鼠随机分为2组，每组12只，全部经脾静脉注射秋水仙碱（0.4 mL/kg），建立大鼠肝脏不同叶、段的不均匀损伤模型。造模术后第3天，大鼠麻醉后行MR检查，肝脏轴位平扫后，一组先行Gd-EOB-DTPA的增强MR检查，间隔24 h后，再行Gd-DTPA的增强MR检查；另一组大鼠采用相反顺序间隔24 h分别注入2种造影剂行增强MR检查。在MR图像上，分别在大鼠肝脏左、右叶和脊柱旁肌肉组织采集平扫抑脂T1WI的肝脏与肌肉信号比（LMR）、2种造影剂增强后的肝脏强化值［ELMR=（增强后LMR-平扫LMR）/平扫LMR］。分别计算每只大鼠2种造影剂增强后肝脏左、右叶ELMR的差值（ΔELMR）。MR检查后留取肝脏标本进行病理学损伤评分。比较肝脏左、右叶以上各参数的差异，分析ELMR与病理学评分的相关性。结果 所有大鼠经脾静脉注射秋水仙碱3 d后肝实质可见病理学改变，肝脏左、右叶损伤病理评分、ELMR差异有统计学意义（P<0.05）；Gd-DTPA和Gd-EOB-DTPA的ELMR与病理学评分呈负相关（r=-0.532，P<0.001；r=-0.865，P<0.001）。Gd-EOB-DTPA的ΔELMR大于Gd-DTPA （P<0.05）。结论 造影剂Gd-EOB-DTPA和Gd-DTPA的MR增强检查对评价急性肝损伤都具有应用价值，且Gd-EOB-DTPA优于Gd-DTPA。

肝特异性造影剂与细胞外造影剂增强磁共振定量检测不均匀肝损伤的实验研究

于占江¹, 王国庆¹, 王志强², 陈智成¹, 刘屹¹

1. 中国医科大学附属第一医院放射科, 沈阳 110001;
2. 北票市中心医院放射科, 辽宁 朝阳 122100

收稿日期:2020-07-23出版日期:2021-05-30发布日期:2021-05-19
通讯作者:刘屹E-mail:liuyicmu@sina.cn
作者简介:于占江(1984-),男,主治医师,硕士研究生.
基金资助:国家自然科学基金（81471719）


关键词: 钆塞酸二钠, 秋水仙碱, 肝损伤, 磁共振成像
Abstract: Objective To assess the value of liver-specific gadolinium ethoxybenzyl diethylenetriamine pentaacetic acid (Gd-EOB-DTPA) and extracellular Gd-DTPA contrast agents in the quantitative detection of rodent heterogeneous hepatic injury with enhanced magnetic resonance imaging (MRI). Methods Twenty-four mature male rats were randomly divided into two groups. All the rats were injected with colchicine (0.4 mL/kg) via the splenic vein to induce heterogeneous hepatic injury. Three days later,all the rats underwent an MR examination of the liver. After an axial pre-enhanced scan,Gd-EOB-DTPA and Gd-DTPA were used to perform enhanced MRI for the rats of both groups at intervals of 24 h in the reverse order. The following parameters were collected on the same slices,and the signal intensities were measured by placing the region of interest (ROI) on the liver parenchyma and erector spinae muscle,the liver-to-muscle ratio (LMR),the enhanced LMR[ELMR=(LMRpost-enhanced-LMRpre-enhanced)/LMRpre-enhanced] of the hepatic left and right lobe,and the difference in ELMR between the left and right hepatic lobe (ΔELMR). After the MR examination,the liver biopsy was performed for pathological analysis of liver damage. The parameters of the left and right hepatic lobes were compared,and the correlation between ELMR and pathological hepatic injury scores was examined. Results The hepatic injury score and the ELMR were significantly different in the left and right lobes (P<0.05). The correlation between the hepatic injury score and the ELMR was statistically significant (P<0.001). The ΔELMR of Gd-EOB-DTPA was greater than that of Gd-DTPA (P<0.05). Conclusion Although both liver-specific and extracellular contrast agents are useful for the quantitative detection of rodent heterogeneous hepatic injury with enhanced MRI,the effect of liver-specific contrast agents may be better than that of extracellular contrast agents.
Key words: gadolinium ethoxybenzyl diethylenetriamine pentaacetic acid, colchicine, hepatic injury, magnetic resonance imaging
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