使用扩散加权成像检测肝细胞癌的小肝内转移：与常规动态 MRI 的比较。

Detection of small intrahepatic metastases of hepatocellular carcinomas using diffusion-weighted imaging: comparison with conventional dynamic MRI.

机构信息

Department of Radiology and Research Institute of Radiological Science, Gangnam Severance Hospital, Yonsei University College of Medicine, 712 Eonjuro, Seoul 135-720, South Korea.

出版信息

Magn Reson Imaging. 2011 Sep;29(7):985-92. doi: 10.1016/j.mri.2011.04.010. Epub 2011 May 25.

DOI:10.1016/j.mri.2011.04.010

PMID:21616624

Abstract

PURPOSE

The purpose of our study was to compare diffusion-weighted MR imaging (DWI) with conventional dynamic MRI in terms of the assessment of small intrahepatic metastases from hepatocellular carcinoma (HCC).

MATERIALS AND METHODS

In 24 patients with multifocal, small (≤2 cm) intrahepatic metastatic foci of advanced HCC, a total of 134 lesions (≤1 cm, n=81; >1 cm, n=53) were subjected to a comparative analysis of hepatic MRI including static and gadopentetate dimeglumine-enhanced dynamic imaging, and DWI using a single-shot spin-echo echo-planar MRI (b values=50, 400 and 800 s/mm(2)), by two independent reviewers.

RESULTS

A larger number of the lesions were detected and diagnosed as intrahepatic metastases on DWI [Reviewer 1, 121 (90%); Reviewer 2, 117 (87%)] than on dynamic imaging [Reviewer 1, 107 (80%); Reviewer 2, 105 (78%)] (P<.05). For the 81 smaller lesions (≤1 cm), DWI was able to detect more lesions than dynamic imaging [Reviewer 1, 68 (84%) vs. 56 (69%), P=.008; Reviewer 2, 65 (80%) vs. 55 (68%), P=.031], but there was no statistically significant difference between the two image sets for larger (>1 cm) lesions.

CONCLUSION

Due to its higher detection rate of subcentimeter lesions, DWI could be considered complementary to dynamic MRI in the diagnosis of intrahepatic metastases of HCCs.

摘要

目的

本研究旨在比较弥散加权磁共振成像（DWI）与常规动态磁共振成像在评估小肝癌（HCC）肝内转移中的作用。

材料与方法

对 24 例多灶性小（≤2cm）肝内转移性 HCC 患者的 134 个病灶（≤1cm，n=81；＞1cm，n=53）进行了肝 MRI 平扫及钆喷酸葡胺增强动态扫描和单次激发自旋回波平面弥散加权成像（b 值=50、400 和 800s/mm2）的对比分析，由两位独立观察者进行。

结果

DWI 较动态成像（观察者 1：121 个病灶[90%]；观察者 2：117 个病灶[87%]）能检测到和诊断更多的肝内转移灶（观察者 1：107 个病灶[80%]；观察者 2：105 个病灶[78%]）（P<.05）。对于 81 个较小的病灶（≤1cm），DWI 较动态成像能检测到更多的病灶（观察者 1：68 个病灶[84%] vs. 56 个病灶[69%]，P=.008；观察者 2：65 个病灶[80%] vs. 55 个病灶[68%]，P=.031），但在较大病灶（＞1cm）中，两种成像方法之间无统计学差异。