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钆塞酸增强 MRI 与多期多层螺旋 CT 用于评估经影像引导肿瘤治疗的肝细胞癌的存活肿瘤。

Gadoxetic acid-enhanced MRI versus multiphase multidetector row computed tomography for evaluating the viable tumor of hepatocellular carcinomas treated with image-guided tumor therapy.

机构信息

Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea.

出版信息

J Magn Reson Imaging. 2010 Sep;32(3):629-38. doi: 10.1002/jmri.22287.

Abstract

PURPOSE

To compare the diagnostic performance of gadoxetic acid-enhanced MRI with that of multi-phase 40- or 64-multidetector row computed tomography (MDCT) to evaluate viable tumors of hepatocellular carcinomas (HCCs) treated with image-guided tumor therapy.

MATERIALS AND METHODS

A total of 108 patients with 162 HCCs (56 lesions with viable tumor and 106 without viable tumor) treated by means of transcatheter arterial chemoembolization or radiofrequency ablation were retrospectively included in this study. All patients underwent multi-phase CT at 40- or 64-MDCT and gadoxetic acid-enhanced MRI using 3.0 Tesla (T). Two observers independently and randomly reviewed the CT and MR images of the treated lesions. The diagnostic performance of two techniques for the evaluation of the viable tumors in the treated lesions was assessed with a receiver operating characteristic (ROC) analysis.

RESULTS

For each observer, the areas under the ROC curve were 0.953 and 0.969 for MRI, and 0.870 and 0.888 for MDCT (P < 0.05). The diagnostic accuracies (96.3% for each observer) and sensitivities (92.9% and 96.4%) of MRI in two observers were significantly higher than those (82.7% and 80.9%, 53.6% for each observer, respectively) of MDCT (P < 0.001). The negative predictive values (96.3% and 98.1%) of MRI in two observers were significantly higher than those (80.0% and 79.5%) of MDCT (P < 0.001). For each observer, specificities and positive predictive values did not differ significantly between the two techniques (P > 0.05).

CONCLUSION

Gadoxetic acid-enhanced MRI shows better diagnostic performance than that of MDCT for evaluating the viable tumors of HCCs treated with image-guided tumor therapy.

摘要

目的

比较钆塞酸增强 MRI 与多期 40 或 64 层多排 CT(MDCT)在评估经影像引导肿瘤治疗的肝细胞癌(HCC)活性肿瘤中的诊断性能。

材料与方法

回顾性纳入 108 例 162 个 HCC 患者(56 个有活性肿瘤病灶,106 个无活性肿瘤病灶),这些患者均接受经导管动脉化疗栓塞或射频消融治疗。所有患者均在 40 或 64-MDCT 和 3.0T 磁共振成像(MRI)上进行多期增强扫描。两名观察者独立且随机地对治疗后病灶的 CT 和 MRI 图像进行评估。采用受试者工作特征(ROC)曲线分析两种技术评估治疗后活性肿瘤的诊断性能。

结果

对于每位观察者,MRI 的 ROC 曲线下面积分别为 0.953 和 0.969,MDCT 分别为 0.870 和 0.888(P < 0.05)。两名观察者的 MRI 诊断准确率(96.3%)和敏感度(92.9%和 96.4%)明显高于 MDCT(82.7%和 80.9%,53.6%)(P < 0.001)。两名观察者的 MRI 阴性预测值(96.3%和 98.1%)明显高于 MDCT(80.0%和 79.5%)(P < 0.001)。对于每位观察者,两种技术的特异性和阳性预测值差异均无统计学意义(P > 0.05)。

结论

对于评估经影像引导肿瘤治疗的 HCC 活性肿瘤,钆塞酸增强 MRI 比 MDCT 的诊断性能更好。

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