Department of Radiology, University of Michigan, Ann Arbor, Michigan 48109, USA.
J Magn Reson Imaging. 2010 Aug;32(2):360-6. doi: 10.1002/jmri.22271.
To determine the diagnostic utility of delayed hypointensity and delayed enhancing rim on magnetic resonance imaging (MRI) as indicators of hepatocellular carcinoma (HCC) in arterially enhancing nodules < or =5 cm in the cirrhotic liver and determine the features that best predict HCC.
Gadolinium-enhanced MRI studies performed from January 2001 to December 2004 in patients with cirrhosis were evaluated for arterially enhancing nodules measuring < or =5 cm. Verification was via explant correlation, biopsy, or imaging follow-up. Sensitivity and specificity of diagnostic features of HCC were calculated. Features predictive of HCC were determined using the Generalized Estimating Equation approach.
In all, 116 arterially enhancing nodules were identified in 80 patients (<2 cm: n = 79, 2-5 cm n = 37). Sensitivity and specificity of delayed hypointensity for HCC measuring < or =5 cm, 2-5 cm, and <2 cm were 0.54 (40 of 74) and 0.86 (36 of 42); 0.72 (23 of 32) and 0.80 (4 of 5); and 0.41 (17 of 42) and 0.87 (32 of 37). For the delayed enhancing rim sensitivity and specificity were 0.64 (47 of 74) and 0.86 (36 of 42); 0.75 (24 of 32) and 1.0 (5 of 5); and 0.55 (23 of 42) and 0.83 (31 of 37), respectively. Lesion size (> or =2 cm) and delayed enhancing rim, as main features and their interaction, were the most significant predictors of HCC.
Delayed hypointensity and enhancing rim improve the specificity of diagnosis of HCC of all sizes but are seen less frequently in small (<2 cm) HCC. Nodule size (> or =2 cm) and delayed enhancing rim are the strongest predictors of HCC.
确定磁共振成像（MRI）中延迟低信号和延迟增强边缘作为肝硬化肝脏中 <或= 5cm 动脉增强结节的肝细胞癌（HCC）指标的诊断效用，并确定最佳预测 HCC 的特征。
对 2001 年 1 月至 2004 年 12 月进行的 MRI 增强检查进行评估，纳入肝硬化患者的动脉增强结节直径 <或= 5cm。通过切除物相关性、活检或影像学随访来进行验证。计算 HCC 诊断特征的敏感性和特异性。使用广义估计方程方法确定 HCC 的预测特征。
共发现 80 例患者的 116 个动脉增强结节（<2cm：n = 79，2-5cm：n = 37）。<或= 5cm、2-5cm 和 <2cm 的 HCC 患者延迟低信号的敏感性和特异性分别为 0.54（74 例中的 40 例）和 0.86（42 例中的 36 例）、0.72（32 例中的 23 例）和 0.80（5 例中的 5 例）和 0.41（42 例中的 17 例）和 0.87（37 例中的 32 例）。对于延迟增强边缘，敏感性和特异性分别为 0.64（74 例中的 47 例）和 0.86（42 例中的 36 例）、0.75（32 例中的 24 例）和 1.0（5 例中的 5 例）和 0.55（42 例中的 23 例）和 0.83（37 例中的 31 例）。病变大小（>或=2cm）和延迟增强边缘，作为主要特征及其相互作用，是 HCC 的最强预测因素。
延迟低信号和增强边缘提高了各种大小 HCC 的诊断特异性，但在较小 (<2cm) HCC 中则较少见。结节大小（>或=2cm）和延迟增强边缘是 HCC 的最强预测因素。
