Department of Radiology, Wonkwang University School of Medicine, Iksan, Republic of Korea.
Imaging Science Research Center, Wonkwang University Hospital, Iksan, Republic of Korea.
Eur J Radiol. 2018 May;102:95-101. doi: 10.1016/j.ejrad.2018.02.032. Epub 2018 Feb 27.
To study whether the measurement of hepatic fibrosis on gadolinium-ethoxybenzyl-diethylenetriamine pentaacetic acid (Gd-EOB-DTPA) magnetic resonance (MR) imaging using the coefficient of variation (CV) might be correlated with the presence of hepatocellular carcinoma (HCC) in patients with chronic hepatitis B (CHB).
This study included 104 patients with and without CHB, who were divided into 4 groups: control group, CHB without liver cirrhosis (LC; Group I), CHB with LC (Group II), and CHB with LC and HCC (Group III). MR images were analyzed to measure the inhomogeneity of signal intensities calculated using the CV map of the liver parenchyma. Intergroup comparisons of CV values were performed using ANOVA. The diagnostic performance of the CV map and alpha-fetoprotein (AFP) for diagnosing HCC was evaluated using the receiver operating characteristic (ROC) curve.
On the hepatobiliary phase of Gd-EOB-DTPA-enhanced T1-weighted imaging, the mean CV values of the control group and Groups I, II, and III were 3.9 ± 0.99, 3.97 ± 1.09, 5.58 ± 2.05, and 6.80 ± 2.34, respectively (P = 0.000). On ROC analysis of the CV value for predicting HCC, the value of the area under the curve (AUC) on Gd-EOB-DTPA MR imaging was 0.788 (95% CI: 0.697-0.862). The sensitivity and specificity were 84.2% and 63.6%, respectively, at a CV cutoff value >4.75. The value of AUC determined using AFP was 0.766.
The CV value for hepatic fibrosis on Gd-EOB-DTPA MR imaging may be correlated with the presence of HCC in patients with CHB, and shows comparable diagnostic performance to AFP analysis.
研究慢性乙型肝炎（CHB）患者使用变异系数（CV）测量钆塞酸二钠（Gd-EOB-DTPA）磁共振成像（MR）肝纤维化是否与肝细胞癌（HCC）的存在相关。
本研究纳入了 104 例 CHB 患者和非 CHB 患者，将其分为 4 组：对照组、无肝硬化的 CHB（CHB 无 LC；I 组）、有肝硬化的 CHB（CHB 有 LC；II 组）和有 LC 及 HCC 的 CHB（CHB 有 LC 及 HCC；III 组）。通过分析 MR 图像，使用肝实质 CV 图来测量信号强度不均度。使用方差分析比较组间 CV 值。使用受试者工作特征（ROC）曲线评估 CV 图和甲胎蛋白（AFP）对 HCC 的诊断性能。
在 Gd-EOB-DTPA 增强 T1 加权成像的肝胆期，对照组和 I、II、III 组的平均 CV 值分别为 3.9±0.99、3.97±1.09、5.58±2.05 和 6.80±2.34（P=0.000）。在 Gd-EOB-DTPA MR 成像预测 HCC 的 CV 值 ROC 分析中，曲线下面积（AUC）值为 0.788（95%CI：0.697-0.862）。CV 值>4.75 的截断值时，诊断 HCC 的灵敏度和特异性分别为 84.2%和 63.6%。使用 AFP 确定的 AUC 值为 0.766。
Gd-EOB-DTPA MR 成像肝纤维化的 CV 值可能与 CHB 患者 HCC 的存在相关，与 AFP 分析具有相当的诊断性能。
