Kim Seung Kwon, Kim Seung Hoon, Lee Won Jae, Kim Hana, Seo Jung Wook, Choi Dongil, Lim Hyo K, Lee Soon Jin, Lim Jae Hoon
Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50, Ilwon-Dong, Kangnam-Ku, Seoul 135-710, Korea.
AJR Am J Roentgenol. 2002 Sep;179(3):741-50. doi: 10.2214/ajr.179.3.1790741.
The purpose of our study was to compare the diagnostic accuracy and lesion conspicuity of ferumoxides-enhanced MR imaging with those of mangafodipir trisodium-enhanced MR imaging for the preoperative detection of hepatocellular carcinoma.
Twenty-one patients with 39 hepatocellular carcinomas underwent ferumoxides-enhanced and mangafodipir trisodium-enhanced MR imaging. The diagnosis was established by pathologic examination after surgical resection in all patients. Five MR sequences were obtained 30 min after ferumoxides administration, and two MR sequences were obtained before and 15 min after mangafodipir trisodium administration. Three observers independently interpreted both MR images of all sequences on a segment-by-segment basis. The diagnostic accuracy of MR imaging was assessed using receiver operating characterizing analysis. Lesion (hepatocellular carcinoma > 10 mm in diameter)-to-liver contrast-to-noise ratio was calculated on MR images.
Ferumoxides-enhanced MR imaging (A(z) = 0.971) was significantly more accurate (p < 0.05) than mangafodipir trisodium-enhanced MR imaging (A(z) = 0.950). The mean sensitivity of ferumoxides-enhanced MR imaging (86%) was significantly greater (p < 0.05) than that of mangafodipir trisodium-enhanced MR imaging (44%) in lesions smaller than 10 mm. The mean lesion-to-liver contrast-to-noise ratio of hepatocellular carcinoma on ferumoxides-enhanced MR imaging (13.7 +/- 8.8) was significantly greater than on mangafodipir trisodium-enhanced MR imaging (5.4 +/- 5.1) (p < 0.01).
Ferumoxides-enhanced MR imaging has superior diagnostic accuracy in lesions smaller than 10 mm and superior lesion conspicuity compared with mangafodipir trisodium-enhanced MR imaging for the preoperative detection of hepatocellular carcinoma.
我们研究的目的是比较超顺磁性氧化铁增强磁共振成像与锰福地匹三钠增强磁共振成像对肝细胞癌术前检测的诊断准确性及病变显示清晰度。
21例患有39个肝细胞癌的患者接受了超顺磁性氧化铁增强和锰福地匹三钠增强磁共振成像检查。所有患者均在手术切除后通过病理检查确诊。在注射超顺磁性氧化铁30分钟后获取5个磁共振序列，在注射锰福地匹三钠前及注射后15分钟获取2个磁共振序列。三名观察者逐段独立解读所有序列的两组磁共振图像。使用受试者操作特征分析评估磁共振成像的诊断准确性。在磁共振图像上计算病变（直径>10mm的肝细胞癌）与肝脏的对比噪声比。
超顺磁性氧化铁增强磁共振成像（A(z)=0.971）的准确性显著高于锰福地匹三钠增强磁共振成像（A(z)=0.950）（p<0.05）。在直径小于10mm的病变中，超顺磁性氧化铁增强磁共振成像的平均敏感度（86%）显著高于锰福地匹三钠增强磁共振成像（44%）（p<0.05）。超顺磁性氧化铁增强磁共振成像上肝细胞癌的平均病变与肝脏对比噪声比（13.7±8.8）显著高于锰福地匹三钠增强磁共振成像（5.4±5.1）（p<0.01）。
对于肝细胞癌的术前检测，与锰福地匹三钠增强磁共振成像相比，超顺磁性氧化铁增强磁共振成像在直径小于10mm的病变中具有更高的诊断准确性及更好的病变显示清晰度。
