超顺磁性氧化铁增强磁共振成像用于肝脏局灶性病变：与动脉门静脉造影CT及肝动脉造影CT的比较

Superparamagnetic iron oxide-enhanced MR imaging for focal hepatic lesions: a comparison with CT during arterioportography plus CT during hepatic arteriography.

作者信息

Tanimoto Akihiro, Wakabayashi Go, Shinmoto Hiroshi, Nakatsuka Seishi, Okuda Shigeo, Kuribayashi Sachio

机构信息

Department of Diagnostic Radiology, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan.

出版信息

J Gastroenterol. 2005 Apr;40(4):371-80. doi: 10.1007/s00535-005-1553-8.

DOI:10.1007/s00535-005-1553-8

PMID:15870974

Abstract

BACKGROUND

We aimed to evaluate the efficacy of a breath-hold superparamagnetic iron oxide (SPIO)-enhanced magnetic resonance (MR) imaging protocol for the detection of focal hepatic lesions, in comparison with a non-breath-hold SPIO-enhanced imaging protocol and computed tomography during arterioportography (CTAP) plus CT during hepatic arteriography (CTHA).

METHODS

Findings of SPIO-enhanced MR imaging and CTAP/CTHA for 24 hepatic metastases in 17 patients and 29 HCCs in 21 patients were analyzed. All patients underwent breath-hold SPIO-enhanced MR imaging (1.5 tesla), breath-hold plus non-breath-hold SPIO-enhanced MR imaging, and CTAP plus CTHA prior to partial hepatectomy or laparoscopic ablation therapy. Histopathology for lesion characterization and intraoperative ultrasound for lesion detection were available for all patient. Breath-hold SPIO-enhanced MR imaging consisted of T2-weighted single-short fast spin echo (FSE), T2-weighted (T2W) FSE, T2*-weighted gradient echo (GRE), and T1-weighted GRE. For the non-breath-hold imaging protocol, respiratory-triggered, fat-suppressed T2W-FSE was added to the breath-hold MR imaging protocol. Double phase CTAP plus CTHA was performed on an angio-CT system. To compare the three imaging protocols, three radiologists performed blind film reading, and all data, on a hepatic segment-to-segment basis, were entered for alternative free-response receiver-operating characteristic (AFROC) analysis.

RESULTS

ROC analysis showed that there was no significant difference in the area under the AFROC curve (A1) value for metastases and HCCs among the three protocols; the breath-hold SPIO-enhanced MR imaging protocol, non-breath-hold MR imaging protocol, and CTAP plus CTHA. The breath-hold SPIO-enhanced MR imaging protocol showed a sensitivity, specificity, and accuracy equivalent to the non-breath-hold MR imaging protocol and CTAP plus CTHA.

CONCLUSIONS

As a preoperative test, SPIO-enhanced MR imaging could have the potential to replace CTAP plus CTHA in a certain clinical setting.

摘要

背景

我们旨在评估屏气超顺磁性氧化铁（SPIO）增强磁共振（MR）成像方案在检测局灶性肝病变方面的疗效，并与非屏气SPIO增强成像方案以及动脉门静脉造影（CTAP）加肝动脉造影（CTHA）期间的计算机断层扫描（CT）进行比较。

方法

分析了17例患者中24个肝转移灶以及21例患者中29个肝细胞癌（HCC）的SPIO增强MR成像和CTAP/CTHA的结果。所有患者在接受部分肝切除术或腹腔镜消融治疗之前，均接受了屏气SPIO增强MR成像（1.5特斯拉）、屏气加非屏气SPIO增强MR成像以及CTAP加CTHA检查。所有患者均有用于病变特征描述的组织病理学检查结果以及用于病变检测的术中超声检查结果。屏气SPIO增强MR成像包括T2加权单次快速自旋回波（FSE）、T2加权（T2W）FSE、T2*加权梯度回波（GRE）以及T1加权GRE。对于非屏气成像方案，在屏气MR成像方案中增加了呼吸触发、脂肪抑制的T2W-FSE。在血管CT系统上进行双期CTAP加CTHA检查。为比较这三种成像方案，三名放射科医生进行了盲法读片，并将所有基于肝段的数据输入进行交替自由响应接收器操作特征（AFROC）分析。