Department of Radiology, Research Institute of Radiological Science, Yonsei University College of Medicine, Seoul, Republic of Korea.
J Magn Reson Imaging. 2012 Mar;35(3):635-43. doi: 10.1002/jmri.22880. Epub 2011 Nov 16.
To assess the incremental value of hepatobiliary phase images in gadoxetate disodium-enhanced magnetic resonance imaging (MRI), and to compare diagnostic accuracy and lesion conspicuity on 10- and 20-minute delayed images for preoperative detection of hepatic metastases with subgroup analysis according to size and history of chemotherapy.
Forty-six patients with 107 metastases who underwent surgery after gadoxetate disodium-enhanced MRI were evaluated. Four observers independently interpreted three sets: dynamic set comprising precontrast T1-, T2-weighted, and dynamic images; 10-minute set comprising dynamic set and 10-minute delayed; 20-minute set comprising 10-minute set and 20-minute delayed. Diagnostic accuracy was compared with subgroup analysis. Liver-to-lesion signal ratio (SR) was calculated using the region of interest method and compared.
Mean A(z) and sensitivities were significantly higher for 10- (A(z) = 0.894, sensitivity = 95.6%) and 20-minute (0.910, 97.2%) than dynamic set (0.813, 79.9%) (P < 0.001), with no significant difference between 10- and 20-minute sets (P = 0.140). In patients with small (≤1 cm) metastases and a history of chemotherapy, sensitivities were significantly higher with 10- (88.2%) and 20-minute (91.6%) sets than dynamic set (48.6%) (P < 0.001). SR was significantly higher for 10- and 20-minute delayed than precontrast and dynamic, with significantly higher SR on 20- than 10-minute delayed.
Regardless of size or prior chemotherapy, detection of hepatic metastases was significantly improved by adding hepatobiliary phase images without significant differences between 10- and 20-minute delayed.
评估钆塞酸二钠增强磁共振成像（MRI）肝胆期图像的附加价值，并通过亚组分析（按大小和化疗史进行分组）比较术前检测肝转移的 10 分钟和 20 分钟延迟图像的诊断准确性和病灶显著性。
对 46 例经钆塞酸二钠增强 MRI 检查并随后手术的 107 处转移灶患者进行评估。4 名观察者分别独立解读三组图像：动态组包括平扫 T1 加权、T2 加权和动态图像；10 分钟组包括动态组和 10 分钟延迟图像；20 分钟组包括 10 分钟组和 20 分钟延迟图像。通过亚组分析比较诊断准确性和计算感兴趣区的肝与病灶信号比（SR）并进行比较。
10 分钟（A（z）=0.894，敏感性=95.6%）和 20 分钟（0.910，97.2%）组的平均 A（z）和敏感性明显高于动态组（0.813，79.9%）（P<0.001），但 10 分钟和 20 分钟组之间无明显差异（P=0.140）。在小（≤1cm）转移灶和化疗史患者中，10 分钟（88.2%）和 20 分钟（91.6%）组的敏感性明显高于动态组（48.6%）（P<0.001）。10 分钟和 20 分钟延迟的 SR 明显高于平扫和动态，20 分钟延迟的 SR 明显高于 10 分钟延迟。
无论病灶大小或既往化疗情况如何，添加肝胆期图像均能显著提高肝转移的检测率，且 10 分钟和 20 分钟延迟图像之间无显著差异。
