Bartolozzi Carlo, Donati Francescamaria, Cioni Dania, Procacci Carlo, Morana Giovanni, Chiesa Antonio, Grazioli Luigi, Cittadini Giorgio, Cittadini Giuseppe, Giovagnoni Andrea, Gandini Giovanni, Maass Jochen, Lencioni Riccardo
Department of Radiology, University of Pisa, Via Roma 67, 56100, Pisa, Italy.
Eur Radiol. 2004 Jan;14(1):14-20. doi: 10.1007/s00330-003-1966-9. Epub 2003 Aug 9.
The aim of this study was to compare unenhanced MRI, MnDPDP-enhanced MRI, and spiral CT in the detection of hepatic colorectal metastases. Forty-four patients with hepatic colorectal metastases were examined with unenhanced and MnDPDP-enhanced MRI and with unenhanced and contrast-enhanced spiral CT. The MR examination protocol included baseline T1-weighted spin-echo (SE), T1-weighted gradient-recalled-echo (GRE), and T2-weighted fast-SE sequences; and T1-weighted SE and T1-weighted GRE sequences obtained 30-60 min after administration of 0.5 micromol/kg (0.5 ml/kg) mangafodipir trisodium (MnDPDP). Images were interpreted by three blinded readers. Findings at CT and MRI were compared with those at intraoperative US, which were used as term of reference. Intraoperative US detected 128 metastases. In a lesion-by-lesion analysis, the overall detection rate was 71% (91 of 128) for spiral CT, 72% (92 of 128) for unenhanced MRI, and 90% (115 of 128) for MnDPDP-enhanced MRI. MnDPDP-enhanced MRI was more sensitive than either unenhanced MRI ( p<0.0001) or spiral CT ( p=0.0007). In a patient-by-patient analysis, agreement with gold standard was higher for MnDPDP-enhanced MRI (33 of 44 cases) than for spiral CT (22 of 44 cases, p=0.0023) and unenhanced MRI (21 of 44 cases, p=0.0013). MnDPDP-enhanced MRI is superior to unenhanced MRI and spiral CT in the detection of hepatic colorectal metastases.
本研究旨在比较非增强MRI、锰福地匹三钠增强MRI和螺旋CT在检测肝结直肠癌转移灶方面的效果。44例肝结直肠癌转移患者接受了非增强和锰福地匹三钠增强MRI检查以及非增强和增强螺旋CT检查。MR检查方案包括基线T1加权自旋回波（SE）、T1加权梯度回波（GRE）和T2加权快速SE序列；以及在静脉注射0.5微摩尔/千克（0.5毫升/千克）锰福地匹三钠（MnDPDP）后30 - 60分钟获得的T1加权SE和T1加权GRE序列。图像由三位不知情的阅片者解读。将CT和MRI的检查结果与术中超声的结果进行比较，术中超声结果作为参考标准。术中超声检测到128个转移灶。在逐个病灶分析中，螺旋CT的总体检出率为71%（128个中的91个），非增强MRI为72%（128个中的92个），锰福地匹三钠增强MRI为90%（128个中的115个）。锰福地匹三钠增强MRI比非增强MRI（p<0.0001）和螺旋CT（p = 0.0007）更敏感。在逐个患者分析中，锰福地匹三钠增强MRI与金标准的一致性高于螺旋CT（44例中的22例，p = 0.0023）和非增强MRI（44例中的21例，p = 0.0013）。在检测肝结直肠癌转移灶方面，锰福地匹三钠增强MRI优于非增强MRI和螺旋CT。
