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肝硬化大鼠肝细胞癌的检测与特征分析:磁共振阳性和阴性对比剂联合使用的诊断价值

Detection and characterization of hepatocellular carcinoma in rats with liver cirrhosis: diagnostic value of combined use of MR positive and negative contrast agents.

作者信息

Guo Dong-Mei, Qiu Tian-Shuang, Bian Jie, Liu Shu-Feng, Wang Chang-Zheng

机构信息

Department of Electronic Engineering, Dalian University of Technology, Dalian 116024, China.

出版信息

Hepatobiliary Pancreat Dis Int. 2009 Feb;8(1):65-70.

PMID:19208518
Abstract

BACKGROUND

Gadolinium-enhanced multi-phase dynamic imaging has improved the accuracy of the diagnosis of hypervascular hepatocellular carcinoma (HCC), but using gadolinium-enhanced dynamic imaging alone is problematic in evaluating hypovascular HCC. This work aimed at evaluating the combined use of superparamagnetic iron oxide (SPIO)-enhanced and gadolinium set in distinguishing HCCs from regenerative nodules (RNs) in a rat model induced by diethylnitrosamine (DEN).

METHODS

DEN-induced HCC model rats (n=40) and control rats (n=10) were studied. From weeks 16 to 19 after DEN administration, 4 animals were scanned every week. The hepatic changes were tested with a 1.5 Tesla magnet, and MR images of SPIO-enhanced and gadolinium set were obtained. According to the pathologic changes, the tumorigenesis was divided into HCC and RN (diameter of nodules > or =3 mm). Diagnostic accuracy of the combined SPIO-enhanced and gadolinium set and the gadolinium set alone was evaluated using receiver-operating characteristic curves. Sensitivity and specificity of the combined SPIO-enhanced and gadolinium set and the gadolinium set alone were calculated.

RESULTS

The listed tests were completed in 29 rats (21 treated and 8 controls). One hundred and six nodules (82 HCCs, 24 RNs) were analyzed. The Az value and sensitivity with the combined SPIO-enhanced and gadolinium set (Az 0.94, sensitivity 0.96) were higher than those with the gadolinium set alone (Az 0.92, sensitivity 0.89). Using the combined SPIO-enhanced and gadolinium set led to detection of 6 nodules which were negative in the gadolinium set alone and 3 nodules were correctly characterized.

CONCLUSION

Using the combined SPIO-enhanced and gadolinium set improved the detectability of HCCs and the SPIO-enhanced imaging compensated for the gadolinium set in differentiating HCCs from RNs in a rat model.

摘要

背景

钆增强多期动态成像提高了富血管性肝细胞癌(HCC)诊断的准确性,但单独使用钆增强动态成像在评估乏血管性HCC时存在问题。本研究旨在评估超顺磁性氧化铁(SPIO)增强成像与钆增强成像联合应用于二乙基亚硝胺(DEN)诱导的大鼠模型中区分HCC与再生结节(RN)的效果。

方法

对DEN诱导的HCC模型大鼠(n = 40)和对照大鼠(n = 10)进行研究。在给予DEN后第16至19周,每周对4只动物进行扫描。使用1.5特斯拉磁体检测肝脏变化,并获取SPIO增强成像和钆增强成像的磁共振图像。根据病理变化,将肿瘤发生分为HCC和RN(结节直径≥3 mm)。使用受试者操作特征曲线评估SPIO增强成像与钆增强成像联合应用及单独使用钆增强成像的诊断准确性。计算SPIO增强成像与钆增强成像联合应用及单独使用钆增强成像的敏感性和特异性。

结果

29只大鼠(21只处理组和8只对照组)完成了所列检测。分析了106个结节(82个HCC,24个RN)。SPIO增强成像与钆增强成像联合应用的Az值和敏感性(Az 0.94,敏感性0.96)高于单独使用钆增强成像(Az 0.92,敏感性0.89)。使用SPIO增强成像与钆增强成像联合应用检测出6个单独使用钆增强成像呈阴性的结节,且3个结节得到正确特征描述。

结论

在大鼠模型中,SPIO增强成像与钆增强成像联合应用提高了HCC的可检测性,且SPIO增强成像在区分HCC与RN方面弥补了钆增强成像的不足。

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