Department of Radiology, Kobe University Graduate School of Medicine, Chuoku, Kobe 650-0017, Japan.
Magn Reson Imaging. 2013 Jan;31(1):17-22. doi: 10.1016/j.mri.2012.06.012. Epub 2012 Aug 13.
The purpose of this study was to assess the efficacy of arterial-dominant phase images of gadolinium-ethoxybenzyl-diethylenetriamine pentaacetic acid (EOB)-enhanced magnetic resonance imaging (MRI) for evaluation of arterial blood supply in hepatocellular carcinoma (HCC) in comparison with that of multiphasic dynamic computed tomography (CT). This study comprised 30 patients (22 men and 8 women, mean age: 68.0 years) with 40 pathologically proven HCCs (well differentiated: 3, moderately differentiated: 30, poorly differentiated: 7, mean diameter: 45.1 mm), all of whom underwent EOB-enhanced MRI and dynamic CT preoperative assessment. Regions of interest were placed over HCCs and the adjacent normal liver, and signal intensities or CT values were measured by two experienced abdominal radiologists on the arterial-dominant phase images of EOB-enhanced MRI and dynamic CT images. HCC-to-liver contrasts [Michelson's contrast: C(M)=(S(HCC)-S(Liver))/(S(HCC)+S(Liver))] were calculated and compared among the modalities. HCC-to-liver contrasts were also visually scored on a 5-point scale and compared. The mean C(M) and visual score for dynamic CT were significantly higher than those for EOB-enhanced MRI. Good agreements were obtained among the two observers. Dynamic CT is a more suitable modality than EOB-enhanced MRI for evaluation of arterial blood supply in HCC. This should be taken into account for diagnosis and management of HCC.
本研究旨在评估钆塞酸二钠（EOB）增强磁共振成像（MRI）动脉期图像在评估肝细胞癌（HCC）动脉血供方面的效能，并与多期动态 CT 进行比较。本研究纳入 30 例（男 22 例，女 8 例；平均年龄：68.0 岁）经病理证实的 HCC 患者（高分化：3 例，中分化：30 例，低分化：7 例；平均直径：45.1mm），均行 EOB 增强 MRI 和动态 CT 术前评估。在动脉期 EOB 增强 MRI 和动态 CT 图像上，对 HCC 和相邻正常肝组织进行感兴趣区（ROI）勾画，由 2 名有经验的腹部放射科医生测量信号强度或 CT 值。计算 HCC 与肝的对比[Michelson 对比：C（M）=（S（HCC）-S（肝脏））/（S（HCC）+S（肝脏））]，并对各模态进行比较。同时对 HCC 与肝的对比进行 5 分制视觉评分，并进行比较。动态 CT 的平均 C（M）和视觉评分显著高于 EOB 增强 MRI。两名观察者之间具有良好的一致性。与 EOB 增强 MRI 相比，动态 CT 是评估 HCC 动脉血供更合适的模态。这在 HCC 的诊断和治疗中应予以考虑。
