Department of Diagnostic Radiology, Research Institute of Clinical Medicine, Chonbuk National University Hospital and Medical School, JeonJu, Republic of Korea.
Clin Radiol. 2010 May;65(5):358-65. doi: 10.1016/j.crad.2009.11.012. Epub 2010 Mar 15.
To compare the diagnostic accuracy and sensitivity of gadoxetic acid-enhanced MRI and superparamagnetic iron oxide (SPIO)-enhanced magnetic resonance imaging (MRI) for the detection of hepatocellular carcinoma (HCC).
Eighty-nine patients (118 HCCs) who underwent three-dimensional gadoxetic acid-enhanced MRI and SPIO-enhanced MRI with a mean interval of 4.7 days (range 3-7 days), were included in this study. Two observers reviewed the gadoxetic acid set (unenhanced, early dynamic, 10 and 20 min hepatocyte-phase images) and SPIO set [unenhanced and ferucarbotran-enhanced T1-, T2-turbo spin-echo (TSE), and T2* weighted imaging (WI)] in consensus. Diagnostic accuracy and sensitivity were evaluated using the alternative-free response receiver operator characteristic (ROC) method.
The area under ROC curve (Az value) and sensitivity of the gadoxetic acid set (Az 0.964; sensitivity 90.7%) were significantly higher than those of the SPIO set (Az 0.830; sensitivity 84.7%; p<0.05). There were 14 and seven lesions that were verified only on the gadoxetic acid set and only on the SPIO set, respectively. Four HCCs were clearly revealed as hypointense only on gadoxetic acid-enhanced hepatocyte phase imaging, but were occult on other sequences, including the SPIO set.
Gadoxetic acid-enhanced MRI is better than SPIO-enhanced MRI for the detection of HCCs.
比较钆塞酸增强 MRI 和超顺磁性氧化铁（SPIO）增强磁共振成像（MRI）在肝细胞癌（HCC）检测中的诊断准确性和敏感度。
本研究共纳入 89 例（118 个 HCC）患者，这些患者在平均间隔 4.7 天（3-7 天）内行三维钆塞酸增强 MRI 和 SPIO 增强 MRI 检查。两名观察者对钆塞酸（平扫、早期动态、10 分钟和 20 分钟肝细胞期图像）和 SPIO（平扫和 Ferucarbotran 增强 T1、T2 涡轮自旋回波（TSE）和 T2*加权成像（WI））进行了一致性评价。使用无替代反应的接收器操作特性（ROC）曲线法评估诊断准确性和敏感度。
ROC 曲线下面积（Az 值）和钆塞酸组的敏感度（Az 值为 0.964；敏感度为 90.7%）明显高于 SPIO 组（Az 值为 0.830；敏感度为 84.7%；p<0.05）。分别有 14 个和 7 个病灶仅在钆塞酸组和 SPIO 组中得到证实。4 个 HCC 在仅在钆塞酸增强的肝细胞期成像上表现为低信号，而在其他序列（包括 SPIO 组）上则表现为隐匿性。
与 SPIO 增强 MRI 相比，钆塞酸增强 MRI 更有助于 HCC 的检测。
