Noguchi Yumi, Murakami Takamichi, Kim Tonsok, Hori Masatoshi, Osuga Keigo, Kawata Syuji, Kumano Seishi, Okada Atsuya, Sugiura Takashi, Nakamura Hironobu
Department of Radiology, Osaka University Graduate School of Medicine, 2-2 Yamadaoka, Suita, Osaka 5650871, Japan.
AJR Am J Roentgenol. 2003 Feb;180(2):455-60. doi: 10.2214/ajr.180.2.1800455.
Three-dimensional (3D) Fourier transformation-enhanced fast gradient-echo sequences with a special spectral inversion recovery pulse and fat suppression developed for abdominal imaging, including MR angiography, can show enhanced areas clearly. The purpose of this study was to evaluate the efficacy of dynamic MR imaging with the pulse sequences for the detection of hypervascular hepatocellular carcinoma by comparing it with that of dynamic helical CT with double arterial phase imaging.
Fifty-three patients with 103 hypervascular hepatocellular carcinoma nodules who underwent both dynamic MR imaging with 3D Fourier transformation-enhanced fast gradient-echo sequences with a special spectral inversion recovery pulse and dynamic helical CT with double arterial phase imaging were enrolled in the study. For dynamic MR imaging, unenhanced, arterial, portal venous, and equilibrium phase images were obtained before and approximately 19, 60, and 120 sec, respectively, after injection of gadopentetate dimeglumine. Three observers independently interpreted the images obtained with each technique in a blinded manner and in random order.
Mean sensitivity and positive predictive values of CT for hypervascular hepatocellular carcinoma (66% and 97%, respectively) were higher than those of MR imaging (63% and 96%, respectively), but there was no significant difference in detecting sensitivity among the observers (p < 0.05). CT and MR imaging were complementary, with some tumors undetected by CT but revealed on MR imaging. There was also no significant difference in A(z) values between CT (0.74) and MR imaging (0.71) (p < 0.05).
Dynamic MR imaging with 3D Fourier transformation-enhanced fast gradient-echo sequences with a special spectral inversion recovery pulse is recommended to improve the detection of hypervascular hepatocellular carcinoma nodules in addition to the use of dynamic helical CT with double arterial phase imaging.
为腹部成像（包括磁共振血管造影）开发的具有特殊频谱反转恢复脉冲和脂肪抑制功能的三维（3D）傅里叶变换增强快速梯度回波序列能够清晰显示强化区域。本研究的目的是通过将其与双动脉期动态螺旋CT进行比较，评估使用该脉冲序列的动态磁共振成像检测富血供肝细胞癌的有效性。
本研究纳入了53例患有103个富血供肝细胞癌结节的患者，这些患者均接受了使用具有特殊频谱反转恢复脉冲的3D傅里叶变换增强快速梯度回波序列的动态磁共振成像以及双动脉期动态螺旋CT检查。对于动态磁共振成像，在注射钆喷酸葡胺之前及之后分别于大约19秒、60秒和120秒获取平扫、动脉期、门静脉期和平衡期图像。三名观察者以盲法和随机顺序独立解读每种技术获得的图像。
CT对富血供肝细胞癌的平均敏感度和阳性预测值（分别为66%和97%）高于磁共振成像（分别为63%和96%），但观察者之间的检测敏感度无显著差异（p<0.05）。CT和磁共振成像具有互补性，一些CT未检测到的肿瘤在磁共振成像上显示出来。CT（0.74）和磁共振成像（0.71）的A(z)值也无显著差异（p<0.05）。
除了使用双动脉期动态螺旋CT外，建议使用具有特殊频谱反转恢复脉冲的3D傅里叶变换增强快速梯度回波序列进行动态磁共振成像，以提高富血供肝细胞癌结节检测的准确性。
