Background/Objectives:Hepatocyte-specific contrast agent (Gd-EOB-DTPA) can improve the detection of liver lesions during MRI-guided thermal ablation. This study aimed to assess the impact of contrast agent administration on the delineation of the ablation zone during therapy monitoring.Methods:From 2010 to 2020, 358 patients with primary and secondary hepatic malignancies underwent MRI-guided thermoablation. A total of 27 patients with 30 liver lesions received Gd-EOB-DTPA during the procedure to improve target lesion visibility (Group 1), while 30 patients with 30 lesions underwent MRI-guided thermoablation without contrast administration (Group 2). T1-weighted volumetric interpolated breath-hold examination (VIBE) sequences were used for intraprocedural imaging, and post-procedural control imaging involved intravenous Gadobutrol administration in both groups. The contrast-to-noise ratio (CNR) was assessed for three key structures: the target lesion before applicator placement, the ablation zone during unenhanced therapy monitoring, and the ablation zone in contrast-enhanced control imaging. A statistical comparison of CNR values between the two groups was performed using the non-parametric Wilcoxon test (p< 0.05).Results:The CNR of lesions in group 1 significantly increased following the administration of Gd-EOB-DTPA. During therapy monitoring, the ablation zone in group 2 exhibited a significantly higher CNR compared to group 1 (median: 7.9 vs. 2.1;p< 0.001). Similarly, at the contrast-enhanced final control, the CNR of the ablation zone remained significantly greater in group 2 than in group 1 (median: 7.7 vs. 2.0;p< 0.001).Conclusions:The administration of a hepatocyte-specific contrast agent (Gd-EOB-DTPA) prior to intervention improves the visualization of liver lesions that are poorly demarcated but significantly reduces the contrast of the ablation zone during intra- and post-procedural imaging. Therefore, its use should be reserved for cases in which the target lesion cannot be sufficiently delineated without contrast.
背景/目的：肝细胞特异性对比剂（钆塞酸二钠）可提升磁共振引导下热消融术中肝脏病灶的检出率。本研究旨在评估治疗监测过程中对比剂注射对消融区边界勾画的影响。方法：2010年至2020年间，358例原发性和继发性肝脏恶性肿瘤患者接受磁共振引导热消融治疗。其中27例患者的30个肝脏病灶在术中注射钆塞酸二钠以增强靶病灶显影（第1组），另30例患者的30个病灶则在未使用对比剂的情况下接受磁共振引导热消融（第2组）。术中成像采用T1加权容积内插屏气检查序列，术后对照成像两组均静脉注射钆布醇。对三个关键结构的对比噪声比进行评估：消融针置入前的靶病灶、未增强治疗监测中的消融区以及增强对照成像中的消融区。采用非参数Wilcoxon检验对两组间对比噪声比值进行统计学比较（p<0.05）。结果：第1组病灶在注射钆塞酸二钠后对比噪声比显著提升。治疗监测期间，第2组消融区的对比噪声比显著高于第1组（中位数：7.9比2.1；p<0.001）。同样在增强终末对照成像中，第2组消融区的对比噪声比仍显著大于第1组（中位数：7.7比2.0；p<0.001）。结论：干预前使用肝细胞特异性对比剂（钆塞酸二钠）可改善边界不清肝脏病灶的可视化效果，但会显著降低术中及术后成像中消融区的对比度。因此，该对比剂应仅限用于未增强成像无法充分显示靶病灶的病例。
肿瘤(癌症)患者之家