Marin Daniele, Di Martino Michele, Guerrisi Antonino, De Filippis Gianmaria, Rossi Massimo, Ginanni Corradini Stefano, Masciangelo Raffaele, Catalano Carlo, Passariello Roberto
Department of Radiological Sciences, University of Rome La Sapienza, Viale Regina Elena 324, Rome 00161, Italy.
Radiology. 2009 Apr;251(1):85-95. doi: 10.1148/radiol.2511080400.
To prospectively investigate whether combined interpretation of dynamic and hepatobiliary phase magnetic resonance (MR) images can improve the accuracy of gadobenate dimeglumine-enhanced MR imaging in the detection of hepatocellular carcinoma (HCC) compared with either dynamic MR or multiphasic multidetector computed tomographic (CT) images alone.
Institutional review board approval and informed patient consent were obtained. Fifty-two patients (39 men, 13 women; mean age, 68 years; range, 38-81 years) suspected of having HCC underwent gadobenate dimeglumine-enhanced MR imaging and multiphasic 64-section multidetector CT. Images were qualitatively analyzed independently by three observers in three separate reading sessions. The alternating free-response receiver operating characteristic (AFROC) method was used to analyze the results. Differences in sensitivity and positive predictive values were calculated at a statistical significance of P < .05.
A total of 67 HCCs were detected in 36 patients. The mean area under the AFROC curve (A(z)) was significantly higher for either the combined interpretation of dynamic and hepatobiliary phase MR images (A(z) = 0.95) or dynamic MR images alone (0.91) than for CT images (0.77) (P = .01 for both comparisons). The mean sensitivity of combined interpretation of MR images (0.72) was significantly higher than those of dynamic MR images alone (0.63) and multidetector CT images (0.61) (P = .008 and .001, respectively). The mean positive predictive value was not significantly different among the three imaging sets.
The combined interpretation of dynamic and hepatobiliary phase MR images improves diagnostic accuracy of gadobenate dimeglumine-enhanced MR imaging for the detection of HCC compared with either dynamic MR or multiphasic multidetector CT images alone.
前瞻性研究与单独的动态磁共振（MR）图像或多期多层螺旋计算机断层扫描（CT）图像相比，动态和肝胆期MR图像的联合解读能否提高钆贝葡胺增强MR成像检测肝细胞癌（HCC）的准确性。
获得机构审查委员会批准并取得患者知情同意。52例疑似患有HCC的患者（39例男性，13例女性；平均年龄68岁；范围38 - 81岁）接受了钆贝葡胺增强MR成像和64层多排螺旋CT多期扫描。三位观察者在三个独立的读片环节对图像进行定性分析。采用交替自由反应接受者操作特征（AFROC）方法分析结果。计算敏感性和阳性预测值的差异，P <.05具有统计学意义。
36例患者共检测出67个HCC。动态和肝胆期MR图像联合解读（A(z)=0.95）或仅动态MR图像（0.91）的AFROC曲线下平均面积（A(z)）显著高于CT图像（0.77）（两种比较P均 =.01）。MR图像联合解读的平均敏感性（0.72）显著高于仅动态MR图像（0.63）和多排螺旋CT图像（0.61）（分别为P =.008和.001）。三种成像方式的平均阳性预测值无显著差异。
与单独的动态MR或多期多层螺旋CT图像相比，动态和肝胆期MR图像的联合解读提高了钆贝葡胺增强MR成像检测HCC的诊断准确性。
