Braga Helio J V, Choti Michael A, Lee Vivian S, Paulson Erik K, Siegelman Evan S, Bluemke David A
Russell H. Morgan Department of Radiology and Radiological Sciences, Johns Hopkins University School of Medicine, 600 N Wolfe St, Baltimore, MD 21287, USA.
Radiology. 2002 May;223(2):525-31. doi: 10.1148/radiol.2232010908.
The purpose of this study was to compare, by means of receiver operating characteristic (ROC) analysis, dual-phase helical computed tomography (CT) and manganese-enhanced magnetic resonance (MR) imaging in the detection and characterization of hepatic lesions in patients prior to surgery.
Twenty-five patients known to have or suspected of having hepatic lesions who were eligible for surgery underwent dual-phase (ie, arterial and portal phase) helical CT and phased-array MR imaging (ie, unenhanced fast spin-echo T2-weighted imaging and gradient-echo T1-weighted imaging performed before and after administration of mangafodipir trisodium). All images were reviewed independently by three off-site blinded reviewers who separately reviewed the CT scans and MR images. The standard of reference was findings at surgery, intraoperative ultrasonography (US), and histopathologic examination. ROC curves were established to analyze the results for each reader and modality.
Ninety-four lesions (77 malignant and 17 benign) were revealed at surgery, intraoperative US, and/or histopathologic examination. The overall rate of lesion detection for the three readers at CT was 81.9% +/- 7.8, 90.4% +/- 5.9, and 76.6% +/- 8.6. At MR imaging, the detection rates were 72.3% +/- 9.0, 71.3% +/- 9.1, and 69.1% +/- 9.3 (P =.001 for the difference between MR and CT). The average rate of false-positive diagnoses in patients was 14.1% at CT and 6.4% at MR imaging (P =.06 for the difference between MR and CT). The mean areas under the alternative-free-response ROC curves were 0.74 for MR and 0.72 for CT (P =.751, not significant).
In detection and characterization of liver lesions, manganese-enhanced MR imaging and dual-phase helical CT were not statistically different.
本研究旨在通过接受者操作特征（ROC）分析，比较双期螺旋计算机断层扫描（CT）和锰增强磁共振（MR）成像在术前患者肝脏病变检测及特征描述方面的效果。
25例已知患有或疑似患有肝脏病变且适合手术的患者接受了双期（即动脉期和门静脉期）螺旋CT及相控阵MR成像（即未增强快速自旋回波T2加权成像以及在注射三钠锰福地匹后进行的梯度回波T1加权成像）。所有图像由三名异地的盲法阅片者独立审查，他们分别审查CT扫描图像和MR图像。参考标准为手术、术中超声（US）及组织病理学检查结果。建立ROC曲线以分析每位阅片者及每种检查方式的结果。
手术、术中US及/或组织病理学检查共发现94个病变（77个恶性病变和17个良性病变）。三位阅片者对CT的病变总体检出率分别为81.9%±7.8、90.4%±5.9和76.6%±8.6。在MR成像中，检出率分别为72.3%±9.0、71.3%±9.1和69.1%±9.3（MR与CT之间的差异P = 0.001）。患者的平均假阳性诊断率在CT为14.1%，在MR成像为6.4%（MR与CT之间的差异P = 0.06）。替代自由反应ROC曲线下的平均面积在MR为0.74，在CT为0.72（P = 0.751，无显著性差异）。
在肝脏病变的检测及特征描述方面，锰增强MR成像和双期螺旋CT在统计学上无差异。
