Diagnostic Radiology, Hiroshima University Hiroshima, Japan.
J Magn Reson Imaging. 2013 Mar;37(3):684-91. doi: 10.1002/jmri.23855. Epub 2012 Oct 10.
To investigate the detectability of hepatocellular carcinoma (HCC) on Gd-EOB-enhanced MR images (Gd-EOB-MRI), we performed tumor-by-tumor analysis of pathologically confirmed tumors using explants from cirrhotic patients who had undergone liver transplantation.
We studied 11 explanted livers and classified the tumor intensity during the arterial phase (AP) and the hepatobiliary phase (HBP) as low in HBP with early enhancement (EE) in AP (A), as high in HBP with EE in AP (B), as low in HBP without EE in AP (C), as high in HBP without EE in AP (D), and as iso-intense in HBP with EE in AP (E). The diagnostic criteria for HCC were (i) pattern A and C, (ii) pattern A and E, (iii) pattern C and E, and (iv) patterns A, C, and E.
Of the 71 HCCs, 22 were not detected at MRI; of these, 9 were moderately differentiated and 13 were well-differentiated HCCs. The sensitivity of Gd-EOB-MRI for diagnostic criteria 1, 2, 3, and 4 was 63.4%, 52.1%, 22.5%, and 69.0%.
The maximum sensitivity of Gd-EOB-MRI for HCC was only 69.0% even when diagnostic criteria that included all previously reported HCC patterns were adopted.
通过对接受过肝移植的肝硬化患者的肝移植标本进行肿瘤逐一分析，研究钆塞酸二钠增强磁共振成像（Gd-EOB-MRI）对肝细胞癌（HCC）的检出能力。
我们研究了 11 个肝移植标本，将动脉期（AP）和肝胆期（HBP）的肿瘤强化程度分为以下 5 种类型：HBP 期低信号伴 AP 期早期强化（A 型）、HBP 期高信号伴 AP 期早期强化（B 型）、HBP 期低信号不伴 AP 期强化（C 型）、HBP 期高信号不伴 AP 期强化（D 型）和 HBP 期等信号伴 AP 期强化（E 型）。HCC 的诊断标准为（i）A 型和 C 型，（ii）A 型和 E 型，（iii）C 型和 E 型，和（iv）A、C 和 E 型。
在 71 个 HCC 中，有 22 个在 MRI 上未被检出；其中，9 个为中分化 HCC，13 个为高分化 HCC。Gd-EOB-MRI 对诊断标准 1、2、3 和 4 的敏感度分别为 63.4%、52.1%、22.5%和 69.0%。
即使采用了包含所有先前报道的 HCC 模式的诊断标准，Gd-EOB-MRI 对 HCC 的最大敏感度也仅为 69.0%。
