钆塞酸二钠（Gd-EOB-DTPA）检测肝细胞癌（HCC）的诊断准确性：与动态对比增强磁共振成像（MRI）和动态对比增强计算机断层扫描（CT）的比较研究
Diagnostic Accuracy of Gd-EOB-DTPA for Detection Hepatocellular Carcinoma (HCC): A Comparative Study with Dynamic Contrast Enhanced Magnetic Resonance Imaging (MRI) and Dynamic Contrast Enhanced Computed Tomography (CT).
作者信息
Imbriaco Massimo, De Luca Serena, Coppola Milena, Fusari Mario, Klain Michele, Puglia Marta, Mainenti Pierpaolo, Liuzzi Raffaele, Maurea Simone
机构信息
Department of Advanced Biomedical Sciences, University "Federico II", Napoli, Italy.
Institute of Biostructure and Bioimaging, National Research Council (CNR), Napoli, Italy.
出版信息
Pol J Radiol. 2017 Feb 1;82:50-57. doi: 10.12659/PJR.899239. eCollection 2017.
BACKGROUND
To compare the diagnostic accuracy of hepato-biliary (HB) phase with gadolinium-ethoxybenzyl-diethylenetriamine-pentaacetic acid (Gd-EOB-DTPA) with dynamic contrast-enhanced MR imaging (DCEMRI) and contrast-enhanced CT (DCECT) for hepatocellular carcinoma (HCC) detection.
MATERIAL/METHODS: 73 patients underwent DCECT and Gd-EOB-DTPA-3T-MR. Lesions were classified using a five-point confidence scale. Reference standard was a combination of pathological evidence and tumor growth at follow-up CT/MR at 12 months. Receiver Operating Characteristic (ROC) curves were obtained.
RESULTS
A total of 125 lesions were confirmed in 73 patients. As many as 74 were HCCs and 51 were benign. Area under the curve (AUC) was 0.984 for DCEMRI+HB phase 0.934 for DCEMRI (<0.68) and 0.852 for DCECT (<0.001). For lesions >20 mm (n.40), AUC was 0.984 for DCEMRI+HB phase, 0.999 for DCEMRI, and 0.913 for DCECT, (=n.s.). For lesions <20 mm (n.85) AUC was 0.982 for DCEMRI+HB phase 0.910 for DCEMRI (<0.01) and 0.828 for DCECT (<0.001).
CONCLUSIONS
The addition of HB phase to DCEMRI provides an incremental accuracy of 4.5% compared to DCEMRI and DCECT for HCC detection. The accuracy of Gd-EOB-DTPA-3T-MR significantly improves for lesions <20 mm. No significant improvement is observed for lesions >20 mm and patients with Child-Pugh class B or C.
背景
比较钆塞酸二钠（Gd-EOB-DTPA）肝胆期（HB）联合动态对比增强磁共振成像（DCEMRI）与对比增强CT（DCECT）检测肝细胞癌（HCC）的诊断准确性。
材料/方法：73例患者接受了DCECT和Gd-EOB-DTPA 3T磁共振检查。采用五点置信度量表对病变进行分类。参考标准为病理证据与12个月随访CT/MR时肿瘤生长情况的综合判断。绘制受试者操作特征（ROC）曲线。
结果
73例患者共确诊125个病变。其中74个为HCC，51个为良性病变。DCEMRI+HB期曲线下面积（AUC）为0.984，DCEMRI为0.934（<0.68），DCECT为0.852（<0.001）。对于直径>20 mm的病变（n = 40），DCEMRI+HB期AUC为0.984，DCEMRI为0.999，DCECT为0.913（P = n.s.）。对于直径<20 mm的病变（n = 85），DCEMRI+HB期AUC为0.982，DCEMRI为0.910（<0.01），DCECT为0.828（<0.001）。
结论
与DCEMRI和DCECT相比，DCEMRI联合HB期检测HCC的准确性提高了4.5%。对于直径<20 mm的病变，Gd-EOB-DTPA 3T磁共振的准确性显著提高。对于直径>20 mm的病变以及Child-Pugh B级或C级患者，未观察到显著改善。
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