간암에서 Ferumoxides와 Gadolinium의 이중 조영 자기공명 영상 = Double Contrast Media enhanced MRI with Ferumoxides- Gadolinium on Hepatocellular Carcinoma

다국어 초록 (Multilingual Abstract)

Purpose: To evaluate the effects of Ferumoxides on Gadolinium (Gd) enhanced dynamic liver magnetic resonance
imaging (MRI) in cirrhotic patients and also for the diagnosis of hepatocellular carcinoma (HCC).
Materials and Methods: 29 patients with liver cirrhosis were examined at 1.5T. 12 patients had HCC. The
imaging protocol included GE T1 in and opposed phases, and a breath-hold TSE T2 before and 30-60 min following
0.05 ml/kg Ferumoxides. Four dynamic in-phase GE series were also acquired after an injection of 20
ml of Gd at 2 ml/sec. SNR and CNR were calculated for liver lesion relative to the muscle and background liver
respectively. Statistical analysis was performed using the paired t-test.
Results: The SNR of the liver decreased by 8.6±1.20 (p<0.001) after Ferumoxides injection. At the peak of
the Gd effect, the liver increased by 6.09±1.15 relative to the post Ferumoxides, but it was not significantly
different from the pre-Ferumoxides study (p<0.01). Although there was no significant change in post
Ferumoxides SNR of HCC, CNR of HCC relative to the liver increased by 7.54±1.61 (p<0.05). After the Gd
injection, CNR of HCC increased by 15.6±3.87 (p<0.05).
Conclusion: The administration of Ferumoxides made HCC CNR increase, and it canceled the effect of Gd enhancement
of the cirrhotic liver. The combination of Ferumoxides and Gd makes HCC CNR increase.

국문 초록 (Abstract)

목적: 만성 간 질환과 간암이 발생한 환자에서 Gadolinium(Gd) 조영증강 동적 자기공명영상에
서 Ferumoxides의 효과를 알아 보고자 한다.
대상과 방법: 29명의 간 경화 환자를 대상으로 하였다. 12명은 간암이 발생한 환자 였다. 몸무
게 당 0.05 ml의 Ferumoxides 주사 전과 주사 후 30-60분에 gradient echo(GE) T1 in phase
와 opposed -phase, breath-hold turbo spin echo(TSE) T2을 얻었고 20 ml의 Gd을 초당
2 ml의 속도로 주사 후에 4 dynamic in-phase GE series를 얻었다. 간과 간암에 대한 signal
to noise ratio(SNR)과 contrast to noise ratio(CNR)을 구하고 paired t-test 를 이용하여 통
계적 분석을 하였다.
결과: Ferumoxides 주사 후 간의 SNR은 8.6±1.20 감소하였다(p<0.001). Gd 주사후 간은
Ferumoxides 주사 후와 비교해 6.09±1.15 증가 하여 Ferumoxides 주사 전과 의미있는 차이
는 없었다(p<0.01). Ferumoxides 주사 후에 간암의 SNR은 의미 있게 변하지 않았으나 배경
간에 대한 간암의 CNR은 7.54±1.61 증가 되었다(p<0.05). Gd은 간암의 CNR을 15.6±3.87
로 더욱 증가 시켰다(p<0.05).
결론: 간암은 Gd으로 조영 증강되고 Ferumoxides는 배경 간의 Gd 조영 증강 효과를 없애기
때문에 Ferumoxides와 Gd의 조합은 간암의 CNR을 높인다.

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