Division of Gastoroenterology and Hepatology, Department of Internal Medicine, Kinki University Faculty of Medicine, Osakasayama, Japan.
Oncology. 2011;81 Suppl 1:66-72. doi: 10.1159/000333264. Epub 2011 Dec 22.
To clarify the diagnostic ability of combining imaging methods to diagnose hepatocellular carcinoma (HCC) using Sonazoid®-enhanced ultrasound (US), gadolinium diethylene-triamine-pentaacetic acid-enhanced (Gd-EOB-DTPA) magnetic resonance imaging (MRI), and contrast-enhanced computed tomography (CECT).
A total of 32 patients who underwent surgical resection for HCC were studied. Sonazoid-enhanced US, Gd-EOB-DTPA MRI, CECT, and intraoperative contrast-enhanced ultrasonography were done for all patients. The definitive diagnosis of HCC in those patients was based on histopathological confirmation.
A total of 50 histologically proven HCCs were obtained from 32 patients; their mean (± SD) age was 68.3 years ± 8.1. The mean (± SD) nodule size was 2.6 cm ± 1.9. Twenty percent were well-differentiated HCC, 64% were moderately differentiated HCC, 10% were poorly differentiated HCC, 4% were combined HCC and CCC, and 2% were HCC with severe necrosis. The overall diagnostic sensitivity of CEUS, CECT, and Gd-EOB-DTPA MRI was 72, 74, and 86%, respectively; however, there was no significant difference between the three imaging modalities in diagnosing typical HCC (p = 0.092). When combining the diagnostic ability of the different imaging modalities, the diagnostic sensitivity of Sonazoid-enhanced US and Gd-EOB-DTPA MRI was 90%, while addition of Sonazoid-enhanced US to CECT and CECT to Gd-EOB-DTPA MRI had a sensitivity of 82 and 88%, respectively. There was no significant difference between the three imaging combinations (p = 0.970).
Sonazoid-enhanced US and Gd-EOB-DTPA MRI can be confidently used in daily clinical practice for the management of HCC.
明确 SonoVue 超声造影、钆塞酸二钠增强磁共振成像（Gd-EOB-DTPA MRI）和对比增强计算机断层扫描（CECT）联合成像方法诊断肝细胞癌（HCC）的诊断能力。
对 32 例行手术切除 HCC 的患者进行了研究。所有患者均行 SonoVue 超声造影、Gd-EOB-DTPA MRI、CECT 和术中超声造影检查。根据组织病理学结果对这些患者的 HCC 进行了明确诊断。
从 32 例患者中获得了 50 个经组织学证实的 HCC，其平均（± SD）年龄为 68.3 岁±8.1 岁。平均（± SD）结节大小为 2.6cm±1.9cm。20%为高分化 HCC，64%为中分化 HCC，10%为低分化 HCC，4%为混合 HCC 和 CCC，2%为 HCC 伴严重坏死。CEUS、CECT 和 Gd-EOB-DTPA MRI 的总体诊断灵敏度分别为 72%、74%和 86%；然而，在诊断典型 HCC 时，三种影像学方法之间没有显著差异（p=0.092）。当结合不同影像学方法的诊断能力时，SonoVue 超声造影和 Gd-EOB-DTPA MRI 的诊断灵敏度为 90%，而 SonoVue 超声造影联合 CECT 和 CECT 联合 Gd-EOB-DTPA MRI 的灵敏度分别为 82%和 88%。三种影像学组合之间无显著差异（p=0.970）。
SonoVue 超声造影和 Gd-EOB-DTPA MRI 可在 HCC 的临床管理中常规使用。
