Department of Radiology, University of Yamanashi, Yamanshi, Japan.
J Magn Reson Imaging. 2011 Aug;34(2):326-35. doi: 10.1002/jmri.22613.
To compare the diagnostic accuracy of contrast-enhanced computed tomography (CE-CT), contrast-enhanced ultrasonography (CE-US), superparamagnetic iron oxide-enhanced magnetic resonance imaging (SPIO-MRI), and gadoxetic acid-enhanced MRI (Gd-EOB-MRI) in the evaluation of colorectal hepatic metastases.
In all, 111 patients with colorectal cancers were enrolled in this study. Of the 112 metastases identified in 46 patients, 31 in 18 patients were confirmed histologically and the remaining 81 in 28 patients were confirmed by follow-up imaging. CE-CT, CE-US, SPIO-MRI, and Gd-EOB-MRI were evaluated. Mean (of three readers, except for CE-US) area under the receiver operating characteristic curve (A(z) ), sensitivities, and positive predictive values (PPV) were calculated. Each value was compared to the others by variance z-test or chi-square test with Bonferroni correction.
For all lesions, mean A(z) and sensitivity of Gd-EOB-MRI (0.992, 95% [56/59]) were significantly greater than those of CE-CT (0.847, 63% [71/112]) and CE-US (0.844, 73% [77/106]). For lesions ≤1 cm, mean A(z) and sensitivity of Gd-EOB-MRI (0.999, 92% [22/24]) were significantly greater than those of CE-CT (0.685, 26% [13/50]) and CE-US (0.7, 41% [18/44]). Mean A(z) (95% CI) of SPIO-MRI for all lesions (0.966 [0.929-0.987]) and lesions ≤ 1 cm (0.961 [0.911-0.988]) were significantly greater than those of CE-CT and CE-US. Mean sensitivity of SPIO-MRI for lesions ≤1 cm (63%, 26/41) was significantly greater than that of CE-CT.
Gd-EOB-MRI and SPIO-MRI were more accurate than CE-CT and CE-US for evaluation of liver metastasis in patients with colorectal carcinoma.
比较对比增强计算机断层扫描（CE-CT）、对比增强超声（CE-US）、超顺磁性氧化铁增强磁共振成像（SPIO-MRI）和钆塞酸增强磁共振成像（Gd-EOB-MRI）在评估结直肠癌肝转移中的诊断准确性。
本研究共纳入 111 例结直肠癌患者。在 46 例患者的 112 个转移灶中，31 个经组织学证实，28 例患者的 81 个转移灶经随访影像学证实。评估了 CE-CT、CE-US、SPIO-MRI 和 Gd-EOB-MRI。计算了三位读者（CE-US 除外）的平均（每个病变）受试者工作特征曲线下面积（A(z)）、敏感度和阳性预测值（PPV）。通过方差 z 检验或卡方检验（Bonferroni 校正）将每个值与其他值进行比较。
对于所有病变，Gd-EOB-MRI 的平均 A(z)和敏感度（0.992，95% [56/59]）显著大于 CE-CT（0.847，63% [71/112]）和 CE-US（0.844，73% [77/106]）。对于直径≤1cm 的病变，Gd-EOB-MRI 的平均 A(z)和敏感度（0.999，92% [22/24]）显著大于 CE-CT（0.685，26% [13/50]）和 CE-US（0.7，41% [18/44]）。对于所有病变（0.966 [0.929-0.987]）和直径≤1cm 的病变（0.961 [0.911-0.988]），SPIO-MRI 的平均 A(z)（95%CI）显著大于 CE-CT 和 CE-US。对于直径≤1cm 的病变，SPIO-MRI 的平均敏感度（63%，26/41）显著大于 CE-CT。
与 CE-CT 和 CE-US 相比，Gd-EOB-MRI 和 SPIO-MRI 对结直肠癌患者肝转移的评估更准确。
