Department of Biomedical Imaging and Radiological Science, National Yang-Ming University, Taipei, Taiwan, ROC.
J Chin Med Assoc. 2011 Feb;74(2):62-8. doi: 10.1016/j.jcma.2011.01.013. Epub 2011 Feb 12.
T1-weighted (T1W) hyperintense nodules against a background of cirrhosis are diagnostically challenging in daily practice. All regenerative nodules, dysplastic nodules and hepatocellular carcinoma (HCC) might present hyperintense on T1W imaging (T1WI), so T1W hyperintense nodules cannot be definitively characterized as dysplastic nodules or HCC before biopsy, resection or transplantation. The purpose of our study was to evaluate Ferucarbotran-enhanced Magnetic Resonance Imaging (MRI) with accumulation-phase fat suppression T1-weighted imaging (FS-T1WI) in comparison with gadolinium-enhanced MRI for characterization of hyperintense nodules on unenhanced T1WI within cirrhotic liver.
Two separate groups of patients with histologically-proven T1W hyperintense nodule on MRI were retrospectively identified. The Ferucarbotran group consisted of 17 T1W hyperintense nodules in 12 patients. The gadolinium group consisted of 22 T1W hyperintense nodules in 21 patients. All of the patients had liver cirrhosis. Finally, 11 HCC nodules, and six benign nodules were included in the Ferucarbotran group; 15 HCC nodules and seven benign nodules were included in the gadolinium group.
With the conventional criteria, in the gadolinium-enhanced group, the sensitivity, specificity, and accuracy were 53%, 100%, and 73%, respectively. Using the conventional criteria in the Ferucarbotran group, the sensitivity, specificity, and accuracy were 73%, 100%, 82%, respectively. Using the conventional criteria plus hyperintense on the accumulation-phase FS-T1WI in the Ferucarbotran group for characterization of the T1W hyperintense nodules, the sensitivity, specificity, and accuracy were 100%, 83%, 94%, respectively. The sensitivity of Ferucarbotran-enhanced MR with accumulation-phase FS-T1WI was better than that of gadolinium-enhanced MRI (p=0.01).
Ferucarbotran-enhanced MR imaging with accumulation-phase FS-T1WI is superior to gadolinium-enhanced MRI in characterization of T1W hyperintense nodules within cirrhotic liver. T1W hyperintense nodule within cirrhotic liver depicting hyperintense on Ferucarbotran-enhanced accumulation-phase FS-T1WI should be investigated aggressively.
在日常实践中，T1 加权（T1W）高信号结节伴肝硬化的诊断具有挑战性。所有再生结节、异型增生结节和肝细胞癌（HCC）在 T1W 成像（T1WI）上可能表现为高信号，因此在进行活检、切除或移植之前，T1W 高信号结节不能明确诊断为异型增生结节或 HCC。我们的研究目的是评估 Ferucarbotran 增强磁共振成像（MRI）与钆增强 MRI 相比，在评估肝硬化肝脏中 T1WI 未增强的高信号结节方面的应用。
回顾性地确定了两组经组织学证实的 MRI 上 T1W 高信号结节的患者。Ferucarbotran 组包括 12 例患者的 17 个 T1W 高信号结节。钆组包括 21 例患者的 22 个 T1W 高信号结节。所有患者均有肝硬化。最终，Ferucarbotran 组包括 11 个 HCC 结节和 6 个良性结节；钆组包括 15 个 HCC 结节和 7 个良性结节。
使用常规标准，在钆增强组中，敏感性、特异性和准确性分别为 53%、100%和 73%。在 Ferucarbotran 组中使用常规标准，敏感性、特异性和准确性分别为 73%、100%和 82%。在 Ferucarbotran 组中，使用常规标准加 Ferucarbotran 增强后积聚期 FS-T1WI 高信号，敏感性、特异性和准确性分别为 100%、83%和 94%。Ferucarbotran 增强 MRI 联合积聚期 FS-T1WI 的敏感性优于钆增强 MRI（p=0.01）。
Ferucarbotran 增强 MRI 联合积聚期 FS-T1WI 在肝硬化肝脏 T1W 高信号结节的特征描述方面优于钆增强 MRI。肝硬化肝脏 T1W 高信号结节在 Ferucarbotran 增强积聚期 FS-T1WI 上呈高信号应积极进行检查。
