超顺磁性氧化铁（SPIO）增强 MRI 检测肝细胞癌（HCC）：扩散加权成像（DWI）的附加价值。

Detection of hepatocellular carcinoma (HCC) using super paramagnetic iron oxide (SPIO)-enhanced MRI: Added value of diffusion-weighted imaging (DWI).

机构信息

Department of Clinical Radiology, Kyushu University, Fukuoka, Japan.

出版信息

J Magn Reson Imaging. 2010 Feb;31(2):373-82. doi: 10.1002/jmri.22059.

DOI:10.1002/jmri.22059

PMID:20099351

Abstract

PURPOSE

To evaluate whether diffusion-weighted imaging (DWI) improves the detection of hepatocellular carcinoma (HCC) on super paramagnetic iron oxide (SPIO)-enhanced MRI.

MATERIALS AND METHODS

This retrospective study group consisted of 30 patients with 50 HCC nodules who underwent MRI at 1.5 Tesla. Two combined MR sequence sets were compared for detecting HCC: SPIO-enhanced MRI (axial T2-weighted fast spin-echo (FSE) and T1-/T2*-weighted fast field echo (FFE) scanned before and after administration of ferucarbotran) and SPIO-enhanced MRI + DWI (SPIO-enhanced MRI with axial DWI scanned before and after administration of ferucarbotran). Three blinded readers independently reviewed for the presence of HCC on a segment-by-segment basis using a four-point confidence scale. The performance of the two combined MR sequence sets was evaluated using receiver operating characteristic (ROC) analysis.

RESULTS

The average area under the ROC curve (Az) of the three readers for the SPIO-enhanced MRI + DWI set (0.870 +/- 0.046) was significantly higher that that for the SPIO-enhanced MRI set (0.820 +/- 0.055) (P = .025). The sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) for detection of HCC were 66.0%, 98.0%, 90.0%, and 91.4%, respectively, for the SPIO-enhanced MRI set, and 70.0%, 98.6%, 92.9%, and 92.4%, respectively, for the SPIO-enhanced MRI + DWI set.

CONCLUSION

The SPIO-enhanced MRI + DWI set outperformed the SPIO-enhanced MRI set for depicting HCC.

摘要

目的

评估弥散加权成像（DWI）是否能提高超顺磁性氧化铁（SPIO）增强 MRI 对肝细胞癌（HCC）的检出率。

材料与方法

本回顾性研究纳入 30 例共 50 个 HCC 结节患者，这些患者在 1.5T 磁共振仪上进行了检查。为了检测 HCC，我们对比了两种联合 MR 序列：SPIO 增强 MRI（轴位 T2 加权快速自旋回波（FSE）和 T1/T2*-加权快速场回波（FFE），分别在注射 Ferucarbotran 前后扫描）和 SPIO 增强 MRI+DWI（SPIO 增强 MRI 轴位 DWI，在注射 Ferucarbotran 前后扫描）。三位盲法阅片者分别对 HCC 结节进行分段评估，采用四点置信度评分。采用受试者工作特征（ROC）曲线分析评估两种联合 MR 序列的性能。

结果

三位阅片者的 SPIO 增强 MRI+DWI 组的 ROC 曲线下面积（Az）平均值（0.870±0.046）显著高于 SPIO 增强 MRI 组（0.820±0.055）（P=0.025）。SPIO 增强 MRI 组的 HCC 检出率分别为 66.0%、98.0%、90.0%和 91.4%，SPIO 增强 MRI+DWI 组的 HCC 检出率分别为 70.0%、98.6%、92.9%和 92.4%。