Jung G, Breuer J, Poll L W, Koch J A, Balzer T, Chang S, Mödder U
Institute for Diagnostic and Interventional Radiology, Kliniken der Landeshauptstadt Düsseldorf, Germany.
Acta Radiol. 2006 Feb;47(1):15-23. doi: 10.1080/02841850500406795.
To evaluate the ability of contrast-enhanced magnetic resonance imaging (MRI) with Gd-EOB-DTPA in comparison with non-enhanced imaging and spiral computed tomography (CT) to provide additional information for classification and characterization of hepatocellular carcinoma.
Forty patients with histopathology-proven hepatocellular carcinoma were selected for this subgroup analysis from a phase-III multicenter study in 235 patients with known or suspected liver lesions. The primary analysis was comparison of the proportion of hepatocellular carcinoma correctly classified and characterized by combined pre-/post-contrast MRI compared with pre-contrast MRI alone or with spiral CT. All images were evaluated on site, and in a blinded reading by three independent readers off site.
In the on-site evaluation, the lesions were correctly classified as a malignant tumor with combined MRI in 90.3%, with pre-contrast imaging alone in 82.9% and with spiral CT in 87.8% (n.s.). The proportion of correct characterization (lesion type diagnosis) with combined MRI was 85.4%, 75.6% for pre-contrast imaging, and 77.5% for spiral CT (n.s.), respectively. In the blinded reading, one reader showed a significant increase in the proportion of correctly characterized lesions by 27% (P<0.05). The other two readers showed a reduction in the proportion of correct characterization by 12% and 15%, respectively (n.s.).
With regard to lesion classification, no difference was found between combined pre-/post-contrast MRI and spiral CT. A non-significant trend in favor of Gd-EOB-DTPA-enhanced MRI with regard to characterization of hepatocellular carcinoma was found, although the CT scans were not optimized as the MRI scans.
评估钆塞酸二钠增强磁共振成像（MRI）与非增强成像及螺旋计算机断层扫描（CT）相比，为肝细胞癌的分类和特征描述提供额外信息的能力。
从一项针对235例已知或疑似肝脏病变患者的III期多中心研究中，选取40例经组织病理学证实为肝细胞癌的患者进行该亚组分析。主要分析是比较对比剂增强前后联合MRI、单纯对比剂增强前MRI或螺旋CT正确分类和特征描述肝细胞癌的比例。所有图像均在现场进行评估，并由三名独立阅片者在非现场进行盲法阅片。
在现场评估中，联合MRI将病变正确分类为恶性肿瘤的比例为90.3%，单纯对比剂增强前成像为82.9%，螺旋CT为87.8%（无统计学差异）。联合MRI正确特征描述（病变类型诊断）的比例分别为85.4%、对比剂增强前成像为75.6%、螺旋CT为77.5%（无统计学差异）。在盲法阅片中，一名阅片者正确特征描述病变的比例显著增加了27%（P<0.05）。另外两名阅片者正确特征描述的比例分别降低了12%和15%（无统计学差异）。
在病变分类方面，对比剂增强前后联合MRI与螺旋CT之间未发现差异。尽管CT扫描未像MRI扫描那样进行优化，但在肝细胞癌特征描述方面发现了有利于钆塞酸二钠增强MRI的非显著趋势。
