Inoue Tatsuo, Kudo Masatoshi, Hatanaka Kinuyo, Takahashi Syunsuke, Kitai Satoshi, Ueda Taisuke, Ishikawa Emi, Hagiwara Satoru, Minami Yasunori, Chung Hobyung, Ueshima Kazuomi, Maekawa Kiyoshi
Division of Gastroenterology and Hepatology, Department of Internal Medicine, Kinki University School of Medicine, Osaka-Sayama, Japan.
Oncology. 2008;75 Suppl 1:48-54. doi: 10.1159/000173424. Epub 2008 Dec 17.
To evaluate the usefulness of vascular phase images of contrast-enhanced ultrasonography (CE-US) with Sonazoid for hepatocellular carcinomas (HCCs), a retrospective, comparative study was conducted of images of HCCs obtained by CE-US and superparamagnetic iron oxide (SPIO) magnetic resonance imaging (MRI) and evaluated qualitatively and quantitatively.
Seventy-seven patients with 88 HCCs who received CE-US and SPIO-MRI were reviewed. The ratio of the echogenicity of the tumor and nontumor areas was calculated with postvascular phase CE-US (postvascular phase ratio). The ratio of the intensity of the nontumor to tumor areas on SPIO-enhanced MRI (SPIO intensity index) was also calculated. The Pearson correlations were calculated for all values between the postvascular phase ratio and SPIO intensity index for quantitative comparison. These images were also compared qualitatively for the detection rate of the tumors.
The sensitivities of CE-US and SPIO-MRI in detecting tumors were 98 and 95%, respectively (nonsignificant, chi(2) test). The postvascular phase ratio correlated with the SPIO intensity index for HCCs (Pearson r = 0.803, p < 0.05). The image conformity of the result from the liver parenchymal phase CE-US and SPIO-MRI was 92%. Dedifferentiation spots of nodule-in-nodule HCCs were detected in 4 (80%) of 5 on postvascular phase images of CE-US, and in 2 (40%) of 5 on SPIO-MRI (nonsignificant, chi(2) test).
Postvascular phase images of CE-US with Sonazoid appear promising as an alternative to SPIO-enhanced MRI. Further study cases are needed to confirm the usefulness of postvascular phase images of CE-US compared to SPIO-MRI for the detection of dedifferentiation foci in hepatic tumors.
为评估使用声诺维的超声造影（CE-US）血管期图像对肝细胞癌（HCC）的诊断价值，开展了一项回顾性比较研究，对通过CE-US和超顺磁性氧化铁（SPIO）磁共振成像（MRI）获得的HCC图像进行定性和定量评估。
回顾了77例患有88个HCC的患者，这些患者均接受了CE-US和SPIO-MRI检查。利用血管期后CE-US计算肿瘤与非肿瘤区域的回声比（血管期后比值）。还计算了SPIO增强MRI上非肿瘤与肿瘤区域的强度比（SPIO强度指数）。计算血管期后比值与SPIO强度指数之间所有值的Pearson相关性以进行定量比较。还对这些图像的肿瘤检出率进行了定性比较。
CE-US和SPIO-MRI检测肿瘤的敏感性分别为98%和95%（无显著性差异，卡方检验）。HCC的血管期后比值与SPIO强度指数相关（Pearson相关系数r = 0.803，p < 0.05）。肝实质期CE-US和SPIO-MRI结果的图像一致性为92%。在CE-US血管期后图像上，5个结节内型HCC中有4个（80%）检测到去分化灶，而在SPIO-MRI上5个中有2个（40%）检测到（无显著性差异，卡方检验）。
使用声诺维的CE-US血管期后图像有望成为SPIO增强MRI的替代方法。需要更多的研究病例来证实与SPIO-MRI相比，CE-US血管期后图像在检测肝肿瘤去分化灶方面的有效性。
