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富血管性肝细胞癌血流动力学成像表现的评估:使用径向容积成像屏气检查及k空间加权图像对比重建的动态对比增强磁共振成像与肝动脉造影期间动态计算机断层扫描的比较

Evaluation of hemodynamic imaging findings of hypervascular hepatocellular carcinoma: comparison between dynamic contrast-enhanced magnetic resonance imaging using radial volumetric imaging breath-hold examination with k-space-weighted image contrast reconstruction and dynamic computed tomography during hepatic arteriography.

作者信息

Kurozumi Masahiro, Fujinaga Yasunari, Kitou Yoshihiro, Yamada Akira, Ohya Ayumi, Adachi Yasuo, Tsukahara Yoshinori, Nickel Marcel D, Maruyama Katsuya, Uehara Takeshi, Miyagawa Shin-Ichi, Kadoya Masumi

机构信息

Department of Radiology, Shinshu University School of Medicine, 3-1-1 Asahi, Matsumoto, 390-8621, Japan.

Radiology Division of Shinshu University Hospital, 3-1-1 Asahi, Matsumoto, 390-8621, Japan.

出版信息

Jpn J Radiol. 2018 Apr;36(4):295-302. doi: 10.1007/s11604-018-0720-9. Epub 2018 Jan 11.

Abstract

PURPOSE

To compare the visualization of hemodynamic imaging findings of hypervascular hepatocellular carcinoma (HCC) on dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) using radial volumetric imaging breath-hold examination with k-space-weighted image contrast reconstruction (r-VIBE-KWIC) versus dynamic computed tomography during hepatic arteriography (dyn-CTHA).

MATERIALS AND METHODS

We retrospectively reviewed the databases of preoperative DCE-MRI using r-VIBE-KWIC, dyn-CTHA, and postoperative pathology of resected specimens. Fourteen patients with 14 hypervascular HCCs underwent both DCE-MRI and dyn-CTHA. The imaging findings of the tumor and adjacent liver parenchyma were assessed on both modalities by two readers. The tumor enhancement time was also compared between the two modalities.

RESULTS

On DCE-MRI/dyn-CTHA, early staining, peritumoral low-intensity or low-density bands, corona enhancement, and washout of HCC were observed in 14/14 (100%), 10/12 (83%), 11/14 (78%), and 4/14 (29%) patients, respectively. Pathologically, four HCCs with low-density bands on dyn-CTHA had no fibrous capsules. The median tumor enhancement time on DCE-MRI and dyn-CTHA was 24 (9-24) and 23 (8-35) s, respectively. The correlation coefficient between the two groups was 0.762 (P < 0.002).

CONCLUSIONS

DCE-MRI using r-VIBE-KWIC has diagnostic potential comparable with that of dyn-CTHA in the hemodynamic evaluation of hypervascular HCC except for the washout phenomenon.

摘要

目的

比较采用径向容积成像屏气检查及k空间加权图像对比重建技术(r-VIBE-KWIC)的动态对比增强磁共振成像(DCE-MRI)与肝动脉造影期间的动态计算机断层扫描(dyn-CTHA)对富血供肝细胞癌(HCC)血流动力学成像结果的显示情况。

材料与方法

我们回顾性分析了使用r-VIBE-KWIC的术前DCE-MRI、dyn-CTHA以及切除标本术后病理的数据库。14例患有14个富血供HCC的患者接受了DCE-MRI和dyn-CTHA检查。两名阅片者对两种检查方式下肿瘤及相邻肝实质的成像结果进行评估。同时比较了两种检查方式下肿瘤的强化时间。

结果

在DCE-MRI/dyn-CTHA上,分别有14/14(100%)、10/12(83%)、11/14(78%)和4/14(29%)的患者观察到HCC的早期强化、瘤周低强度或低密度带、晕环强化以及廓清。病理上,dyn-CTHA显示有低密度带的4个HCC无纤维包膜。DCE-MRI和dyn-CTHA上肿瘤强化时间的中位数分别为24(9 - 24)秒和23(8 - 35)秒。两组之间的相关系数为0.762(P < 0.002)。

结论

除廓清现象外,采用r-VIBE-KWIC的DCE-MRI在富血供HCC的血流动力学评估中具有与dyn-CTHA相当的诊断潜力。

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