超順磁性氧化鐵造影劑於肝臟擴散加權影像的應用

The Application of SPIO-Contrast Agent Used for Liver MR Diffusion Weighted Imaging

李正輝(Cheng-Hui Lee) ； 杜威信(Wea-Shin Do) ； 翁珮珮(Pei-Pei Weng) ； 呂坤木(Kun-Mu Lu) ； 蔡裕豐(Yuh-Feng Tsai) ； 陳良光(Liang-Kuang Chen) ； 蘇振隆(Jenn-Lung Su)

《台灣應用輻射與同位素雜誌》 5卷4期 (2009/12) Pp. 771-779

https://doi.org/10.29832/TJARI.200912.0004

摘要

肝臟腫瘤分列爲男性第一位及女性第二位的高致死率。傳統上使用理學檢查、實驗室血液生化檢查以及影像學方面包括電腦斷層、超音波、磁振造影等方式的檢查做爲診斷的依據。本研究藉由在超順性氧化鐵離子造影劑(super paramagnetic iron oxide; SPIO)注射後實施之擴散加權影像造影(diffusion weighted imaging; DWI)，以提高評估肝臟腫瘤上的正確性。本研究篩選疑似肝臟腫瘤病患10人做爲本研究取樣的對象，實施傳統肝臟磁振造影，以及SPIO注射前所實施的DWI肝臟磁振造影，之後實施一組與DWI波序在幾何條件上完全相符的T1W影像，以提供解剖資訊上影像分析的基礎，並在SPD注射後10分鐘、20分鐘及30分鐘後實施DWI肝臟磁振造影。爲評估DWI肝臟磁振造影的特異性(specificity)，亦選取五名無肝膽系統疾病之健康志願者，實施傳統肝臟磁振攝影及SPIO注射前的DWI肝臟磁振造影，做爲實驗的對照組。結果顯示，本研究所採取的技術，在所有符合評估標準的十名受測病患中皆能準確的偵測出病灶的位置。預期此一結合SPIO-enhanced MR imaging與DWI的技術，作爲一種輔助性的工具，應可普遍應用在臨床MRI造影上。配合傳統肝臟磁振造影及SPIO-enhanced MR imaging的實施相信對臨床上肝臟病灶的偵測上應有絕對的幫助，同時亦可大幅提高臨床上肝臟病灶的偵測率。

關鍵字

磁振造影 ； 肝臓腫瘤 ； 超順化氧化鐵離子造影劑SPIO ； 擴散加權影像造影DWI

並列摘要

Hepatic tumor was the top of deadly diseases for male and the second deadly diseases for female in Taiwan. Traditional, physical examination, laboratory blood test and medical imaging including computer tomography (CT), ultrasound and magnetic resonance imaging (MRI) were used for hepatic lesions diagnosis. The purpose of this study is to evaluate the accuracy of hepatic lesion detection after Super paramagnetic iron oxide (SPIO) injection followed by diffusion weighted imaging (DWI). Ten patients with suspected hepatic tumors were recruited for this study. For each patient, conventional MR liver scanning and pre-SPIO diffusion weighted imaging (DWI) were performed before contrast agent administration. Additional, a T1 weight (T1W) imaging series with the same geometric characterizes was performed for images evaluation. Then 10min, 20min, 30min after SPIO administration DWI were performed. Five volunteers without any biliary system diseases were chosen to perform conventional MR liver scanning and pre-SPIO diffusion weighted imaging (DWI) to evaluate the specificity in this study. The primary result shows that all the present lesions of the ten patients could be detected, Therefore, to be an assisted tool, we expect that by combining this technique with SPIO-enhanced MR imaging and DWI, can become a popular method for hepatic lesions detection in MR scanning. Coordinated with SPIO-enhanced MR imaging and DWI, SPIO-enhanced MR imaging, we believe this technique is useful and can increase the ability of lesion detection ratio significantly.

並列關鍵字

Magnetic Resonance imaging ； Hepatic tumor ； SPIO ； DWI