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肝脏转移瘤的检测:钆塞酸增强三维磁共振成像与铁羧葡胺增强磁共振成像的比较。

Detection of liver metastases: Gadoxetic acid-enhanced three-dimensional MR imaging versus ferucarbotran-enhanced MR imaging.

机构信息

Department of Diagnostic Radiology, Chonbuk National University Hospital and Medical School, Keum Am Dong, JeonJu, Republic of Korea.

出版信息

Eur J Radiol. 2010 Jan;73(1):131-6. doi: 10.1016/j.ejrad.2008.09.027. Epub 2008 Nov 8.

Abstract

PURPOSE

To compare the diagnostic performance of gadoxetic acid-enhanced MRI with ferucarbotran-enhanced MRI for the detection of liver metastases.

MATERIALS AND METHODS

Thirty-six patients with 80 liver metastases who underwent gadoxetic acid-enhanced MRI using a three-dimensional volumetric interpolated technique and ferucarbotran-enhanced MRI with a mean interval of 7 days (range, 5-10 days) were included in this study. Two observers independently interpreted the two sets of images - the gadoxetic acid set (unenhanced, early dynamic and 20min delayed phase images) and the ferucarbotran set (unenhanced and ferucarbotran-enhanced T2*-weighted-gradient echo and T2-weighted turbo spin echo images). Diagnostic accuracy was evaluated using the alternative-free response receiver operator characteristic (ROC) method. Sensitivity and positive predictive value were also evaluated.

RESULTS

There was a trend toward increased areas under the ROC curve (Az values) for the gadoxetic acid set (0.950, 0.948) as compared with the ferucarbotran set (0.941 and 0.939) of images, but no significant difference was found for both observers (p<0.05). Sensitivities of the gadoxetic acid set (93.8% and 92.5%) were also slightly better than those of the ferucarbotran set (88.8% and 87.5%) with no significant difference (p=0.13). The two image sets showed similar positive predictive values (98.7% and 98.6%, respectively).

CONCLUSIONS

Gadoxetic acid-enhanced MRI showed comparable diagnostic performance to ferucarbotran-enhanced MRI for the detection of liver metastases.

摘要

目的

比较钆塞酸增强 MRI 与铁羧葡胺增强 MRI 对肝脏转移瘤的诊断性能。

材料与方法

本研究纳入 36 例患者,共 80 个肝脏转移灶,这些患者均在 7 天(5-10 天)内先后接受了三维容积内插技术钆塞酸增强 MRI 和铁羧葡胺增强 MRI 检查。两位观察者分别对两组图像(钆塞酸组:平扫、早期动态和 20 分钟延迟期图像;铁羧葡胺组:平扫、铁羧葡胺增强 T2*-梯度回波和 T2 加权涡轮自旋回波图像)进行解读。采用二项式无应答者操作特性曲线(ROC)方法评估诊断准确性。同时还评估了敏感性和阳性预测值。

结果

与铁羧葡胺组(观察者 1:0.941、0.939;观察者 2:0.941、0.939)相比,钆塞酸组的 ROC 曲线下面积(Az 值)呈升高趋势(观察者 1:0.950、0.948;观察者 2:0.950、0.948),但差异均无统计学意义(p<0.05)。钆塞酸组的敏感性(观察者 1:93.8%、92.5%;观察者 2:93.8%、92.5%)也略高于铁羧葡胺组(观察者 1:88.8%、87.5%;观察者 2:88.8%、87.5%),但差异均无统计学意义(p=0.13)。两组图像的阳性预测值相似(观察者 1:98.7%、98.6%;观察者 2:98.7%、98.6%)。

结论

对于肝脏转移瘤的诊断,钆塞酸增强 MRI 的性能与铁羧葡胺增强 MRI 相当。

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