Tang Qi, Ma Cong
Department of Surgery, The Second XiangYa Hospital of Central South University, Changsha, Hunan 410011, P.R. China.
Department of Radiology, The Second XiangYa Hospital of Central South University, Changsha, Hunan 410011, P.R. China.
Oncol Lett. 2018 Aug;16(2):2725-2731. doi: 10.3892/ol.2018.8884. Epub 2018 Jun 4.
In 2011, the American College of Radiology released a standardized reporting and data collection system, named Liver Imaging Reporting and Data System (LI-RADS), to improve the consistency of diagnostic imaging examinations of hepatocellular carcinoma (HCC). When the LI-RADS guideline was updated in 2014, hepatobiliary contrast agents, including gadoxetate acid (Gd-EOB-DTPA), were incorporated into the system. However, the diagnostic performance of Gd-EOB-DTPA-enhanced magnetic resonance imaging (MRI) for nodules of different diameters has not been addressed. In the present study, a total of 263 LI-RADS 4 category hepatic nodules were examined blindly and independently by two radiologists. All nodules were divided into two datasets: Set 1 (n=86) that included nodules with iso/hypo-intensity in the arterial phase (HCC, n=42; non-HCC, n=44) and set 2 (n=177) that included nodules with hyper-intensity in the arterial phase (HCC, n=131; non-HCC, n=46). The diagnostic performance of Gd-EOB-DTPA-enhanced MRI for evaluation of nodules with different diameters was evaluated. The present study revealed that the diagnostic performance of Gd-EOB-enhanced MRI of larger nodules (>2 cm) was higher compared with (<2 cm) smaller nodules. The FPR of large nodules (>2 cm) with a hypervascular pattern was lower compared with smaller nodules (<2 cm) with hypovascular pattern. In conclusion, Gd-EOB-enhanced MRI is useful for the diagnosis of HCC where hypervascular LI-RADS 4 nodules are >2 cm in diameter. However, Gd-EOB-enhanced MRI may be of limited use for the assessment of nodules that <20 mm due to low diagnostic performance and high FPR.
2011年，美国放射学会发布了一个标准化报告和数据收集系统，名为肝脏影像报告和数据系统（LI-RADS），以提高肝细胞癌（HCC）诊断性影像检查的一致性。2014年LI-RADS指南更新时，包括钆塞酸二钠（Gd-EOB-DTPA）在内的肝胆对比剂被纳入该系统。然而，Gd-EOB-DTPA增强磁共振成像（MRI）对不同直径结节的诊断性能尚未得到研究。在本研究中，两名放射科医生对总共263个LI-RADS 4类肝脏结节进行了独立的盲法检查。所有结节被分为两个数据集：数据集1（n=86），包括动脉期等/低信号结节（HCC，n=42；非HCC，n=44）；数据集2（n=177），包括动脉期高信号结节（HCC，n=131；非HCC，n=46）。评估了Gd-EOB-DTPA增强MRI对不同直径结节的诊断性能。本研究表明，Gd-EOB增强MRI对较大结节（>2 cm）的诊断性能高于较小结节（<2 cm）。具有高血供模式的大结节（>2 cm）的假阳性率低于具有低血供模式的小结节（<2 cm）。总之，Gd-EOB增强MRI对诊断直径>2 cm的高血供LI-RADS 类别4结节的HCC有用。然而，由于诊断性能低和假阳性率高，Gd-EOB增强MRI对评估<20 mm的结节可能作用有限。
