Kakihara Daisuke, Nishie Akihiro, Harada Noboru, Shirabe Ken, Tajima Tsuyoshi, Asayama Yoshiki, Ishigami Kousei, Nakayama Tomohiro, Takayama Yukihisa, Okamoto Daisuke, Fujita Nobuhiro, Kishimoto Junji, Honda Hiroshi
Department of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University, Higashi-ku, Fukuoka, Japan.
J Magn Reson Imaging. 2014 Nov;40(5):1112-20. doi: 10.1002/jmri.24454. Epub 2013 Nov 20.
To clarify the diagnostic performance of gadoxetic acid-enhanced MRI for the detection of hepatocellular carcinoma (HCC) in recipients of living related-liver transplantation (LRLT).
This retrospective study group consisted of 15 patients with 61 HCCs who each underwent multidetector row computed tomography (MDCT), gadoxetic acid-enhanced MRI, and angiography-assisted computed tomography (CT) before LRLT. The three modalities were compared for their ability to detect HCC. Two blinded readers independently reviewed the images obtained by each modality for the presence of HCC on a segment-by-segment basis using a 5-point confidence scale. The diagnostic performance of the modalities was evaluated in a receiver operating characteristic (ROC) analysis. The area under the ROC curve (Az), sensitivity, specificity, and accuracy were compared for the three modalities.
No significant difference in Az, sensitivity, specificity, or accuracy was obtained among gadoxetic acid-enhanced MRI, MDCT, and angiography-assisted CT for both readers. For reader 1, the sensitivity (55.6%) and the accuracy (84.7%) of angiography-assisted CT were significantly higher than those of MDCT (33.3% and 78.0%) (P < 0.05).
Gadoxetic acid-enhanced MRI has a relatively high diagnostic ability to detect HCC even in recipients of LRLT, equivalent to the abilities of MDCT and angiography-assisted CT.
阐明钆塞酸二钠增强磁共振成像(MRI)对活体肝移植(LRLT)受者肝细胞癌(HCC)的诊断效能。
本回顾性研究组由15例患者共61个HCC组成,这些患者在LRLT前均接受了多排螺旋计算机断层扫描(MDCT)、钆塞酸二钠增强MRI及血管造影辅助计算机断层扫描(CT)。比较这三种检查方法检测HCC的能力。两名盲法阅片者使用5分置信度量表,逐段独立评估每种检查方法所获图像中是否存在HCC。采用受试者操作特征(ROC)分析评估各检查方法的诊断效能。比较三种检查方法的ROC曲线下面积(Az)、敏感性、特异性及准确性。
对于两名阅片者,钆塞酸二钠增强MRI、MDCT及血管造影辅助CT在Az、敏感性、特异性或准确性方面均无显著差异。对于阅片者1,血管造影辅助CT的敏感性(55.6%)和准确性(84.7%)显著高于MDCT(33.3%和78.0%)(P<0.05)。
即使在LRLT受者中,钆塞酸二钠增强MRI对HCC也具有较高的诊断能力,与MDCT及血管造影辅助CT相当。