Gastroenterological Center, Yokohama City University Medical Center, 4-57 Urafune-cho, Minami-ku, Yokohama, Kanagawa 232-0024, Japan.
AJR Am J Roentgenol. 2012 Jan;198(1):106-14. doi: 10.2214/AJR.10.6039.
We evaluated the efficacy of fusion imaging that fuses conventional sonography images with hepatobiliary phase contrast-enhanced MR images obtained with gadolinium-ethoxybenzyl-diethylenetriamine pentaacetic acid (Gd-EOB-DTPA) as the reference image for the detection of hepatocellular carcinomas (HCCs).
Eighty-seven HCCs with a maximum diameter of between 1 and 3 cm at the time of diagnosis were enrolled in this prospective study. We compared the detection rates of HCCs using three sonography modalities: conventional sonography, late phase of contrast-enhanced sonography with Sonazoid, and fusion imaging combining conventional sonography and the hepatobiliary phase of contrast-enhanced MRI with Gd-EOB-DTPA as the reference image. The comparisons were made using the McNemar test.
The detection rate of HCCs using fusion imaging (98%, 85/87) was significantly higher than the detection rates using conventional sonography (76%, 66/87) and contrast-enhanced sonography (83%, 72/87) (p<0.01, for both). For small HCCs (maximum diameter, 1-2 cm), the detection rate using fusion imaging (97%, 59/61) was also significantly higher than those using conventional sonography (66%, 40/61) and contrast-enhanced sonography (80%, 49/61) (p<0.01, for both). The detection rate for atypical HCCs was also significantly higher using fusion imaging (95%, 18/19) than using conventional sonography (53%, 10/19) and contrast-enhanced sonography (26%, 5/19) (p<0.01, for both).
Fusion imaging combining conventional sonography and the hepatobiliary phase of contrast-enhanced MRI with Gd-EOB-DTPA is more sensitive than conventional sonography or contrast-enhanced sonography for detecting HCCs, especially small or atypical HCCs.
我们评估了融合成像的疗效，该方法融合了常规超声图像和钆塞酸二钠（Gd-EOB-DTPA）肝胆期对比增强磁共振成像（MRI）图像作为肝细胞癌（HCC）检测的参考图像。
本前瞻性研究共纳入 87 例诊断时最大直径为 1-3cm 的 HCC 患者。我们比较了三种超声模式（常规超声、超声造影晚期相、融合成像）对 HCC 的检出率，融合成像结合了常规超声和 Gd-EOB-DTPA 肝胆期对比增强 MRI 图像。使用 McNemar 检验进行比较。
融合成像（98%，85/87）检测 HCC 的检出率明显高于常规超声（76%，66/87）和超声造影（83%，72/87）（均 p<0.01）。对于小 HCC（最大直径为 1-2cm），融合成像（97%，59/61）的检出率也明显高于常规超声（66%，40/61）和超声造影（80%，49/61）（均 p<0.01）。对于不典型 HCC，融合成像（95%，18/19）的检出率也明显高于常规超声（53%，10/19）和超声造影（26%，5/19）（均 p<0.01）。
融合成像结合了常规超声和 Gd-EOB-DTPA 肝胆期对比增强 MRI，与常规超声或超声造影相比，对 HCC 的检测更敏感，尤其是对小 HCC 或不典型 HCC 更为敏感。
