Department of Radiology, NYU Langone Medical Center, 560 First Avenue, New York, NY 10016, USA.
Eur Radiol. 2010 Jun;20(6):1431-41. doi: 10.1007/s00330-009-1695-9. Epub 2010 Feb 11.
The full diagnostic value of diffusion-weighted (DW) MRI in the evaluation of liver metastases remains uncertain. The aim of the present study was to assess the diagnostic accuracy of DW-MRI and contrast-enhanced MRI (CE-MRI) using extracellular gadolinium chelates, with the reference standard established by consensus interpretation of confirmatory imaging and histopathologic data.
MR examinations of 51 patients with extrahepatic malignancies were retrospectively reviewed by two independent observers who assessed DW-MRI and CE-MRI for detection of liver metastases.
By reference standard, 93 liver lesions (49 metastases and 44 benign lesions) were identified in 27 patients, 11 patients had no liver lesions, and 13 patients had innumerable metastatic and/or benign lesions. There was no difference in diagnostic performance between the two methods for either observer for the diagnosis of metastatic lesions per patient. For per-lesion analysis, sensitivity of DW-MRI was equivalent to CE-MRI for observer 1 (67.3% vs. 63.3%, p = 0.67), but lower for observer 2 (65.3% vs. 83.7%, p = 0.007). By pooling data from both observers, the sensitivity of DW-MRI was 66.3% (65/98) and 73.5% (72/98) for CE-MRI, with no significant difference (p = 0.171).
DW-MRI is a reasonable alternative to CE-MRI for the detection of liver metastases.
扩散加权（DW）MRI 在评估肝转移中的全面诊断价值仍不确定。本研究旨在评估使用细胞外钆螯合物的 DW-MRI 和对比增强 MRI（CE-MRI）的诊断准确性，参考标准是通过对确认性成像和组织病理学数据的共识解释来建立的。
回顾性分析了 51 例患有肝外恶性肿瘤的患者的 MR 检查，由两位独立观察者评估 DW-MRI 和 CE-MRI 以检测肝转移。
根据参考标准，在 27 名患者中确定了 93 个肝病变（49 个转移灶和 44 个良性病变），11 名患者没有肝病变，13 名患者有无数的转移灶和/或良性病变。对于每个患者的转移性病变的诊断性能，两种方法之间的观察者之间没有差异。对于每例病变的分析，观察者 1 的 DW-MRI 敏感性与 CE-MRI 相当（67.3%比 63.3%，p = 0.67），但观察者 2 的敏感性较低（65.3%比 83.7%，p = 0.007）。通过对两位观察者的数据进行汇总，DW-MRI 的敏感性为 66.3%（65/98），CE-MRI 的敏感性为 73.5%（72/98），无显著差异（p = 0.171）。
DW-MRI 是检测肝转移的 CE-MRI 的合理替代方法。
