Kang Sung Il, Kim Duck-Woo, Cho Jai Young, Park Jihoon, Lee Kyung Ho, Son Il Tae, Oh Heung-Kwon, Kang Sung-Bum
1 Department of Surgery, Seoul National University Bundang Hospital, Seongnam, Korea 2 Department of Radiology, Seoul National University Bundang Hospital, Seongnam, Korea.
Dis Colon Rectum. 2017 Sep;60(9):936-944. doi: 10.1097/DCR.0000000000000914.
The clinical efficacy of gadoxetic acid-enhanced liver MRI as a routine preoperative procedure for all patients with colorectal cancer remains unclear.
The purpose of this study was to evaluate the efficacy of preoperative gadoxetic acid-enhanced liver MRI for the diagnosis of liver metastasis in patients with colorectal cancer.
This was a retrospective analysis from a prospective cohort database.
All of the patients were from a subspecialty practice at a tertiary referral hospital.
Patients who received preoperative gadoxetic acid-enhanced liver MRI after CT and attempted curative surgery for colorectal cancer were included.
The number of equivocal hepatic lesions based on CT and gadoxetic acid-enhanced liver MRI and diagnostic use of the gadoxetic acid-enhanced liver MRI were measured.
We reviewed the records of 690 patients with colorectal cancer. Equivocal hepatic lesions were present in 17.2% of patients based on CT and in 4.5% based on gadoxetic acid-enhanced liver MRI. Among 496 patients with no liver metastasis based on CT, gadoxetic acid-enhanced liver MRI detected equivocal lesions in 15 patients and metastasis in 3 patients. Among 119 patients who had equivocal liver lesions on CT, gadoxetic acid-enhanced liver MRI indicated hepatic lesions in 103 patients (86.6%), including 90 with no metastasis and 13 with metastasis. Among 75 patients who had liver metastasis on CT, gadoxetic acid-enhanced liver MRI indicated that the hepatic lesions in 2 patients were benign, in contrast to CT findings. The initial surgical plans for hepatic lesions according to CT were changed in 17 patients (3%) after gadoxetic acid-enhanced liver MRI.
This study was limited by its retrospective design.
The clinical efficacy of gadoxetic acid-enhanced liver MRI as a routine preoperative procedure for all patients with colorectal cancer is low, in spite of its high diagnostic value for detecting liver metastasis. However, this study showed gadoxetic acid-enhanced liver MRI was helpful in characterizing equivocal hepatic lesions identified in CT and could lead to change in treatment plans for some patients. See Video Abstract at http://links.lww.com/DCR/A420.
钆塞酸二钠增强肝脏磁共振成像（MRI）作为所有结直肠癌患者常规术前检查的临床疗效尚不清楚。
本研究旨在评估术前钆塞酸二钠增强肝脏MRI对结直肠癌患者肝转移的诊断效果。
这是一项基于前瞻性队列数据库的回顾性分析。
所有患者均来自一家三级转诊医院的专科门诊。
纳入在CT检查后接受术前钆塞酸二钠增强肝脏MRI检查并尝试进行结直肠癌根治性手术的患者。
测量基于CT和钆塞酸二钠增强肝脏MRI的可疑肝病变数量以及钆塞酸二钠增强肝脏MRI的诊断应用情况。
我们回顾了690例结直肠癌患者的记录。基于CT检查，17.2%的患者存在可疑肝病变；基于钆塞酸二钠增强肝脏MRI检查，这一比例为4.5%。在496例基于CT检查无肝转移的患者中，钆塞酸二钠增强肝脏MRI检查发现15例患者存在可疑病变，3例患者存在转移。在119例CT检查显示肝病变可疑的患者中，钆塞酸二钠增强肝脏MRI检查显示103例患者（86.6%）存在肝脏病变，其中90例无转移，13例有转移。在75例CT检查发现有肝转移的患者中，钆塞酸二钠增强肝脏MRI检查显示2例患者的肝脏病变为良性，与CT检查结果不同。钆塞酸二钠增强肝脏MRI检查后，17例患者（3%）根据CT制定的肝脏病变初始手术计划发生了改变。
本研究受其回顾性设计的限制。
钆塞酸二钠增强肝脏MRI作为所有结直肠癌患者常规术前检查的临床疗效较低，尽管其对检测肝转移具有较高的诊断价值。然而，本研究表明钆塞酸二钠增强肝脏MRI有助于明确CT检查发现的可疑肝病变的特征，并可能导致部分患者治疗计划的改变。见视频摘要：http://links.lww.com/DCR/A420 。
