Department of Radiology, Chonbuk National University Medical School and Hospital, 20 Geonji-ro, Deokjin-gu, Jeonju, Chonbuk, 54907, South Korea.
Research Institute of Clinical Medicine of Chonbuk National University, Jeonju, South Korea.
Eur Radiol. 2019 Jan;29(1):401-410. doi: 10.1007/s00330-018-5559-z. Epub 2018 Jun 19.
To use Liver Imaging Reporting and Data System (LI-RADS) categorization and features of hepatocellular carcinomas (HCCs) to intraindividually compare gadopentetate dimeglumine-enhanced magnetic resonance imaging (Gd-DTPA-MRI) and gadoxetic acid-enhanced MRI (Gd-EOB-MRI), before and after applying modified major features.
Of 77 HCCs in 64 patients analysed, 17 HCCs were confirmed histopathologically and 46 patients had cirrhosis. Gd-EOB-MRI and Gd-DTPA-MRI were evaluated for the presence of major and ancillary features by two radiologists. LI-RADS categorization was done for Gd-DTPA-MRI (LI-RADS-DTPA) and for Gd-EOB-MRI before and after applying modified major features (hepatobiliary phase [HBP] hypointensity as an additional major feature, LI-RADS-EOBm1; HBP hypointense rim as capsule appearance, LI-RADS-EOBm2; and transitional phase [TP] hypointensity as washout appearance, LI-RADS-EOBm3). Sensitivities of LR-5 categorization for the diagnosis of HCC were compared.
Washout (p=0.012) and capsule appearance (p<0.001) were less frequently observed on Gd-EOB-MRI. Sensitivity for LR-5 categorization was significantly higher with LI-RADS-DTPA compared with LI-RADS-EOB (p=0.001) and LI-RADS-EOBm2 (p=0.004), while sensitivity for LR-5 categorization with LI-RADS-EOBm1 (p=0.210) and LI-RADS-EOBm3 (p=0.727) was comparable.
Modifying LI-RADS for use with Gd-EOB-MRI, such as applying HBP hypointensity as an additional major feature or using TP hypointensity as washout appearance, can improve the sensitivity for the detection of HCC.
• Adding HBP hypointensity as additional major feature improved sensitivity of LR-5 categorization. • Adding TP hypointensity as modified washout appearance improved sensitivity of LR-5 categorization. • Sensitivities for LR-5 classification were comparable between LI-RADS-DTPA, LI-RADS-EOBm1, and LI-RADS-EOBm3.
使用肝脏成像报告和数据系统（LI-RADS）分类和肝细胞癌（HCC）的特征，在个体内比较钆喷酸葡胺增强磁共振成像（Gd-DTPA-MRI）和钆塞酸二钠增强磁共振成像（Gd-EOB-MRI），在应用改良主要特征之前和之后。
在 64 例患者的 77 个 HCC 中，17 个 HCC 经组织病理学证实，46 例患者有肝硬化。两位放射科医生评估了 Gd-EOB-MRI 和 Gd-DTPA-MRI 主要和辅助特征的存在。对 Gd-DTPA-MRI（LI-RADS-DTPA）和应用改良主要特征（肝胆期[HBP]低信号作为附加主要特征，LI-RADS-EOBm1；HBP 低信号边缘作为包膜外观，LI-RADS-EOBm2；过渡期[TP]低信号作为洗脱外观，LI-RADS-EOBm3）前后的 Gd-EOB-MRI 进行 LI-RADS 分类。比较了 LR-5 分类对 HCC 诊断的敏感性。
Gd-EOB-MRI 上观察到洗脱（p=0.012）和包膜外观（p<0.001）的频率较低。与 LI-RADS-EOB（p=0.001）和 LI-RADS-EOBm2（p=0.004）相比，LI-RADS-DTPA 的 LR-5 分类的敏感性显著更高，而 LI-RADS-EOBm1（p=0.210）和 LI-RADS-EOBm3（p=0.727）的 LR-5 分类的敏感性相当。
对 LI-RADS 进行修改以应用于 Gd-EOB-MRI，例如将 HBP 低信号作为附加主要特征，或使用 TP 低信号作为洗脱外观，可提高 HCC 的检测敏感性。
添加 HBP 低信号作为附加主要特征可提高 LR-5 分类的敏感性。
添加 TP 低信号作为改良洗脱外观可提高 LR-5 分类的敏感性。
在 LI-RADS-DTPA、LI-RADS-EOBm1 和 LI-RADS-EOBm3 之间，LR-5 分类的敏感性相当。
