Department of Radiology, Regensburg University School of Medicine, D-93053 Regensburg, Germany.
World J Gastroenterol. 2011 Apr 7;17(13):1739-45. doi: 10.3748/wjg.v17.i13.1739.
To evaluate the benefit and effectiveness of MR-arterioportography (MR-AP) to achieve the highest sensitivity for detection and evaluation of hepatocellular carcinoma (HCC).
Twenty liver cirrhosis patients with suspected HCC were included before transarterial chemoembolization. In all patients double-enhanced Magnetic resonance imaging (MRI) was performed. A bolus of 10 mL Magnevist® was injected through a selectively placed catheter in the superior mesenteric artery and MRI of the liver was performed in arterioportographic phase. Two independent readers evaluated number, size and localization of detected lesions. Diagnostic quality was determined using a 4-point scale. Differences were analyzed for significance using a t-test. Interobserver variability was calculated.
In all 20 patients (100%), MR-AP was feasible. Diagnostic quality was, in all cases, between 1 and 2 for both modalities and readers. MR-AP detected significantly more lesions than double-enhanced MRI (102.5 vs. 61, respectively, P < 0.0024). The inter-observer variability was 0.881 for MRI and 0.903 for MR-AP.
Our study confirmed that the MR-AP as an additional modality for detection of HCC is beneficial, as significantly more lesions were detected compared to MRI with liver-specific contrast.
评估磁共振动脉造影术（MR-AP）在提高肝细胞癌（HCC）检测灵敏度方面的获益和有效性。
在经动脉化疗栓塞术（TACE）前，纳入 20 例疑似 HCC 的肝硬化患者。所有患者均行双期增强磁共振成像（MRI）检查。经肠系膜上动脉选择性置管注射 10ml 钆喷酸葡胺造影剂，行肝动脉期 MRI 检查。两名独立的阅片者评估检出病灶的数量、大小和位置。采用 4 分制评估诊断质量。采用 t 检验分析差异的显著性。计算组内和组间的可重复性。
在所有 20 例患者（100%）中，MR-AP 均可行。两种模态和两位阅片者的诊断质量均为 1 到 2 分。MR-AP 比双期增强 MRI 分别多检出 102.5 个和 61 个病灶（均 P<0.0024）。MRI 的组内和组间可重复性分别为 0.881 和 0.903，MR-AP 分别为 0.903 和 0.903。
本研究证实，MR-AP 作为 HCC 检测的附加手段是有益的，因为与肝特异性对比剂增强 MRI 相比，它可以检出更多的病灶。
