Department of Radiology, Graduate School of Medicine, University of Tokyo, and Department of Radiological Technology, The University of Tokyo Hospital, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655, Japan.
Eur J Radiol. 2011 Nov;80(2):310-5. doi: 10.1016/j.ejrad.2010.07.026. Epub 2010 Aug 21.
To compare the diagnostic performance of Gd-EOB-DTPA-enhanced MRI with that of triple phase 64-MDCT in the detection of hepatocellular carcinoma (HCC).
Thirty-four patients with 52 surgically proven lesions underwent Gd-EOB-DTPA-enhanced MRI and triple phase 64-MDCT. Two observers independently evaluated MR and CT imaging on a lesion-by-lesion basis. Sensitivity, positive and negative predictive values and reproducibility were evaluated. The diagnostic accuracy of each modality was assessed with alternative-free response receiver operating characteristic (ROC) analysis.
Both observers showed higher sensitivity in detecting lesions with MRI compared to CT, however, only the difference between the two imaging techniques for observer 2 was significant (P=0.034). For lesions 1cm or smaller, MRI and CT showed equal sensitivity (both 62.5%) with one observer, and MRI proved superior to CT with the other observer (MRI 75% vs. CT 56.3%), but the latter difference was not significant (P=0.083). The difference in positive and negative predictive value between the two imaging techniques for each observer was not significant (P>0.05). The areas under the ROC curve for each observer were 0.843 and 0.861 for MRI vs. 0.800 and 0.833 for CT and the differences were not significant. Reproducibility was higher using MRI for both observers, but the result was not significant (MRI 32/33 vs. CT 29/33, P=0.083).
Gd-EOB-DTPA-enhanced MRI tended to show higher diagnostic accuracy, sensitivity and reproducibility compared to triple phase 64-MDCT in the detection of hepatocellular carcinoma, however statistical significance was not achieved.
比较钆塞酸二钠增强 MRI 与六四排 MDCT 三期扫描在肝细胞癌（HCC）诊断中的效能。
34 例 52 个经手术证实的病灶患者分别行 Gd-EOB-DTPA 增强 MRI 和六四排 MDCT 三期扫描。两位观察者分别对每例患者的 MR 和 CT 影像进行独立分析。评估了敏感度、阳性和阴性预测值以及可重复性。采用自由选择反应的Receiver Operating Characteristic（ROC）分析评估每种方法的诊断准确性。
两位观察者在检测病灶时均显示出 MRI 的敏感度高于 CT，但仅第二位观察者的两种成像技术之间的差异具有统计学意义（P=0.034）。对于 1cm 或更小的病灶，一位观察者显示 MRI 和 CT 的敏感度相同（均为 62.5%），另一位观察者则显示 MRI 优于 CT（MRI 为 75%，CT 为 56.3%），但差异无统计学意义（P=0.083）。两位观察者的两种成像技术之间的阳性和阴性预测值差异无统计学意义（P>0.05）。每位观察者的 ROC 曲线下面积分别为 MRI 0.843 和 0.861，CT 为 0.800 和 0.833，差异无统计学意义。两位观察者的 MRI 重复性均较高，但差异无统计学意义（MRI 32/33 与 CT 29/33，P=0.083）。
与六四排 MDCT 三期扫描相比，钆塞酸二钠增强 MRI 在肝细胞癌的诊断中具有更高的诊断准确性、敏感度和可重复性，但未达到统计学意义。
