1 Department of Radiology, Duke University Medical Center, 2301 Erwin Rd, Box 3808, Durham, NC 27710.
AJR Am J Roentgenol. 2018 Jun;210(6):1266-1272. doi: 10.2214/AJR.17.18981. Epub 2018 Apr 9.
The purpose of this study is to compare visualization rates of the major features covered by Liver Imaging Reporting and Data System (LI-RADS) version 2014 in patients at risk for hepatocellular carcinoma using either gadobenate dimeglumine or gadoxetate disodium IV contrast agent.
This retrospective study included liver MRI examinations performed with either gadobenate dimeglumine or gadoxetate disodium contrast enhancement. Using age, sex, underlying liver disease, and presence of cirrhosis, patients were placed into matched cohorts. All hepatic nodules 1 cm or larger (up to five per subject) were included, resulting in 63 subjects with 130 nodules (median nodule size, 1.9 cm) imaged with gadobenate and 64 subjects with 117 nodules (median nodule size, 2.0 cm) imaged with gadoxetate. Three radiologists reviewed the studies for LI-RADS major features independently. Bootstrap resampling with 10,000 repetitions was used to compare feature detection rates.
Arterial phase hyperenhancement was seen in a similar number of nodules with gadobenate dimeglumine (mean, 91.5% [119/130]) and gadoxetate disodium (mean, 88.0% [103/117]) (p = 0.173). Dynamic phase washout was more commonly seen with gadobenate dimeglumine (mean, 60.2% [78.3/130]) than with gadoxetate disodium (mean, 45.3% [53/117]) (p = 0.006). The capsule feature was more often visualized with gadobenate dimeglumine (mean, 50.2% [65.3/130]) than with gadoxetate disodium (mean, 33.3% [39/117]) (p < 0.001). Interreader agreement for arterial phase enhancement and dynamic phase washout was almost perfect for both contrast agents (κ > 0.83). Agreement for the capsule feature was moderate for gadobenate dimeglumine (κ = 0.52) and substantial for gadoxetate disodium (κ = 0.67).
The rates of visualization of arterial phase hyperenhancement are similar in studies performed with gadobenate dimeglumine and gadoxetate disodium, but dynamic phase washout and capsule appearance are more commonly visualized with gadobenate dimeglumine.
本研究旨在比较使用钆贝葡胺或钆塞酸二钠 IV 对比剂的患者中，肝脏成像报告和数据系统（LI-RADS）版本 2014 涵盖的主要特征的可视化率。
本回顾性研究包括使用钆贝葡胺或钆塞酸二钠对比增强进行的肝脏 MRI 检查。根据年龄、性别、潜在肝病和肝硬化的存在，将患者分为匹配队列。所有 1cm 或更大的肝结节（每个受试者最多 5 个）均被纳入，结果共有 63 例患者的 130 个结节（中位结节大小 1.9cm）使用钆贝葡胺成像，64 例患者的 117 个结节（中位结节大小 2.0cm）使用钆塞酸成像。三位放射科医生独立对研究结果进行 LI-RADS 主要特征评估。使用 10,000 次重复的 bootstrap 重采样来比较特征检测率。
在使用钆贝葡胺（平均，91.5%[119/130]）和钆塞酸二钠（平均，88.0%[103/117]）的患者中，动脉期强化的结节数量相似（p=0.173）。动态相洗脱在使用钆贝葡胺的患者中更为常见（平均，60.2%[78.3/130]），而在使用钆塞酸二钠的患者中更为常见（平均，45.3%[53/117]）（p=0.006）。在使用钆贝葡胺的患者中，胶囊特征更为常见（平均，50.2%[65.3/130]），而在使用钆塞酸二钠的患者中更为常见（平均，33.3%[39/117]）（p<0.001）。对于两种对比剂，动脉期增强和动态相洗脱的读者间一致性几乎为完美（κ>0.83）。对于胶囊特征，钆贝葡胺的一致性为中度（κ=0.52），钆塞酸二钠的一致性为高度（κ=0.67）。
在使用钆贝葡胺和钆塞酸二钠进行的研究中，动脉期强化的可视化率相似，但动态相洗脱和胶囊外观更常使用钆贝葡胺观察到。
