Goshima Satoshi, Kanematsu Masayuki, Matsuo Masayuki, Murakami Takamichi, Hori Masatoshi, Takamura Manabu, Kondo Hiroshi, Kako Nobuo, Moriyama Noriyuki, Nakamura Hironobu, Hoshi Hiroaki
Department of Radiology, Gifu University School of Medicine, 40 Tsukasamachi, Gifu 500-8705, Japan.
Magn Reson Imaging. 2004 Apr;22(3):379-88. doi: 10.1016/j.mri.2004.01.016.
The purpose of our study was to assess whether respiratory-triggered multishot fast spin echo (MS-FSE) and breath-hold half-Fourier single-shot fast spin echo (SS-FSE) images, in addition to breath-hold T(2)*-weighted gradient recalled echo (GRE) images, increase observer performance in the detection of malignant hepatic tumors with ferumoxide-enhanced magnetic resonance (MR) imaging. Ferumoxide-enhanced MR images obtained from 48 patients with 83 malignant hepatic tumors were retrospectively reviewed by three independent off-site readers. In the first image review, GRE images alone were reviewed. Then, MS-FSE images were added for the first combination review. Finally, SS-FSE images were added for the second combination review. Observer performances were tested by McNemar's test and receiver-operating-characteristic analysis for the clustered data. Sensitivity for hepatocellular carcinomas, metastases, and malignant hepatic tumors overall was significantly (p < 0.05) higher with GRE and MS-FSE combined and GRE, MS-FSE and SS-FSE combined than with GRE alone. For metastases, the Az value was significantly (p < 0.05) higher with GRE and MS-FSE combined, and GRE, MS-FSE and SS-FSE combined than with GRE alone. We confirmed the incremental value of ferumoxide-enhanced MR imaging by obtaining MS-FSE and SS-FSE images in addition to GRE images in the detection of malignant hepatic tumors.
我们研究的目的是评估呼吸触发多激发快速自旋回波（MS-FSE）和屏气半傅里叶单次激发快速自旋回波（SS-FSE）图像，以及屏气T(2)*加权梯度回波（GRE）图像，除了屏气T(2)*加权梯度回波（GRE）图像之外，在使用超顺磁性氧化铁增强磁共振（MR）成像检测恶性肝肿瘤方面是否能提高观察者的表现。对48例患有83个恶性肝肿瘤的患者获得的超顺磁性氧化铁增强MR图像进行回顾性分析，由三位独立的远程阅片者进行评估。在首次图像评估中，仅对GRE图像进行评估。然后，在首次联合评估中加入MS-FSE图像。最后，在第二次联合评估中加入SS-FSE图像。通过McNemar检验和对聚类数据的受试者操作特征分析来测试观察者的表现。对于肝细胞癌、转移瘤和总体恶性肝肿瘤，GRE和MS-FSE联合以及GRE、MS-FSE和SS-FSE联合时的敏感性显著高于单独使用GRE时（p < 0.05）。对于转移瘤，GRE和MS-FSE联合以及GRE、MS-FSE和SS-FSE联合时的Az值显著高于单独使用GRE时（p < 0.05）。我们通过在检测恶性肝肿瘤时除了获取GRE图像之外还获取MS-FSE和SS-FSE图像，证实了超顺磁性氧化铁增强MR成像的增量价值。
