The Comparison Of Diagnostic Value Of Enhanced MRI Between Gd-EOB-DTPA And Gd-DTPA In Colorectal Liver Metastases

Objective:To evaluate the diagnostic value of enhanced MRI between Gd-EOB-DTPA and Gd-DTPA in colorectal liver metastases.Methods:Prospectively collected and retrospectively analyzed 30 patients who were diagnosed colon or rectal cancer in No.1 Hospital of Jilin University from September 2013 to December 2015,they were highly suspected with liver metastasis by ultrasound or CT examination.Inclusion criteria:(1)The patients are more than 18 years old;(2)The patients were diagnosed colorectal cancer in the clinical and histopathological aspect within one month, or the colorectal cancer was after radical resection within six months and the liver les ions did not receive any treatment;(3)The liver metastasis was diagnosed by ultrasound, CT examination or was highly suspected clinically;(4)Patients did not receive any treatment before this study;(5)Patients were in the process of proper treatment and could be followed up or on surgery;(6)Laboratory examination: hepatic function, creatinine,and AFP are normal.Exclusion criteria:(1)Patients who have participated in this study;(2)The patients have allergies or allergic reaction to contrast agent, or the patients are hypersens itive to the allergens(including medicine) or patients who are with obvious thyroid function hyperfunction;(3)Patients who are pregnant or breastfeeding;(4)Patients who have severe liver function damage(such as serum ALT for twice the normal reference value limit);(5)Patients are with renal insufficiency(EGFR < 60 ml/min / 1.73 m2);(6)Patients were unable to accept MRI, such as claustrophobia,with a pacemaker or patients were implanted something that can’t be close to strong magnetic field, etc;(7)Patients were with associated diseases so that they were impossible to finish this test.Patients will take two random checks in three or five days, the enhanced MRI images, by Gd-EOB-DTPA and Gd-DTPA.Two high qualification abdomen image doctors read and write down the numbers of diseases, the enhanced character and enhanced pattern of the diseases respectively and double-blindly, and compare with the final diagnosis lesions and calculate the total diagnosis coincidence rate. All the diseases are divided in four groups by size : ≤0.5cm, 0.6~1.0cm, 1.0cm~2.0cm, >2.0cm.We will take Mc-Nemar inspection to calculate the detection rate of the four groups. In this study,when the inspection results(P < 0.05),we considered it statistically significant.Results :(1)We confirmed 136 metastases by postoperative pathology, liver biopsy, DSA and following up. The check enhanced by Gd-EOB-DTPA checked out 131 metastases,the diagnosis coincidence rate was 96.32%;The check enhanced by Gd-DTPA checked out 115 metastases,the diagnosis coincidence rate was84.56%,P<0.05,they were statistically different.( 2) For those less than 0.5cm lesions, the detection rate of Gd-EOB-DTPA was 13.79%,and that of Gd-DTPA was 3.68%,P<0.05,they were statistically different, too.(3)For the other three groups, they had no statistical differences.Conclusion:(1)The enhanced MRI checked by Gd-EOB-DTPA is better than that of Gd-DTPA in colorectal liver metastasis, so it can be as a routine examination method for the diagnosis of liver metastases.(2)The enhanced MRI checked by Gd-EOB-DTPA has a higher detection rate for those diseases which size are less than 0.5cm.So this study will provide important evidence for the clinical doctors who need tochoose how to treat the diseases.