钆塞酸二乙三胺五乙酸给药后短回波时间反转恢复弥散加权成像中恶性肝肿瘤的显著性。

Conspicuity of Malignant Liver Tumors on Diffusion-Weighted Imaging With Short tau Inversion Recovery After Gadolinium Ethoxybenzyl Diethylenetriaminepentaacetic Acid Administration.

机构信息

Department of Radiological Technology, Kagoshima University Hospital, Kagoshima City, Japan.

Department of Radiology, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima City, Japan.

出版信息

J Magn Reson Imaging. 2019 Feb;49(2):565-573. doi: 10.1002/jmri.26196. Epub 2018 Aug 13.

DOI:10.1002/jmri.26196

PMID:30102432

Abstract

BACKGROUND

Diffusion-weighted imaging (DWI) has been used for the detection and characterization of liver tumors because it has excellent contrast resolution. DWI using short tau inversion recovery (STIR) can improve tumor-to-liver contrast after gadolinium ethoxybenzyl diethylenetriaminepentaacetic acid (Gd-EOB-DTPA) administration that shortens the T relaxation of liver parenchyma.

PURPOSE

To quantitatively and qualitatively compare the conspicuity of malignant liver tumors on DWI after Gd-EOB-DTPA administration between STIR and chemical shift selective (CHESS) sequences.

STUDY TYPE

Single-institution retrospective study.

SUBJECTS

Fifty-seven patients with histologically confirmed malignant liver tumors were evaluated.

FIELD STRENGTH/SEQUENCE: Low b-value DWIs with STIR and CHESS sequences 18-20 minutes after Gd-EOB-DTPA administration were acquired at 1.5T.

ASSESSMENT

Tumor contrast-to-noise ratio (CNR) and visual grade of tumor conspicuity on DWI between STIR and CHESS sequences were compared.

STATISTICAL TESTS

Paired Student's t-test and the Wilcoxon signed rank-test were applied. P < 0.05 was considered statistically significant.

RESULTS

The mean tumor CNR and visual grade of tumor conspicuity on DWI were significantly higher for STIR than for CHESS (both P < 0.001). Regardless of the presence of chronic liver disease, the mean CNR (normal liver 33.5 ± 19.8 vs. 15.7 ± 12.2, P < 0.001; chronic liver disease 19.6 ± 11.0 vs. 9.2 ± 7.8, P < 0.001) and the visual conspicuity grade (normal liver 3.36 ± 0.64 vs. 2.56 ± 0.77, P < 0.001; chronic liver disease 2.94 ± 0.80 vs. 2.25 ± 0.84, P = 0.001) were significantly higher for STIR than for CHESS. Mean CNR and the visual conspicuity grade were also significantly higher for STIR than for CHESS in patients with hepatocellular carcinomas (CNR 18.1 ± 10.5 vs. 8.8 ± 7.2, P < 0.001; visual grade 2.88 ± 0.83 vs. 2.22 ± 0.87, P = 0.001) or metastases (CNR 35.0 ± 19.3 vs. 16.2 ± 13.1, P < 0.001; visual grade 3.45 ± 0.51 vs. 2.59 ± 0.73, P < 0.001).

DATA CONCLUSION

DWI using STIR may be more helpful for depicting malignant liver tumors after Gd-EOB-DTPA administration compared with DWI using CHESS.

LEVEL OF EVIDENCE

3 Technical Efficacy: Stage 2 J. Magn. Reson. Imaging 2019;49:565-573.

摘要

背景

扩散加权成像（DWI）因其具有出色的对比度分辨率而被用于检测和描述肝脏肿瘤。使用短回波时间反转恢复（STIR）的 DWI 可以在钆乙氧基苯甲基二乙三胺五乙酸（Gd-EOB-DTPA）给药后提高肿瘤与肝脏的对比，从而缩短肝脏实质的 T 弛豫时间。

目的

定量和定性比较 Gd-EOB-DTPA 给药后 STIR 和化学位移选择（CHESS）序列上恶性肝脏肿瘤的 DWI 对比。

研究类型

单机构回顾性研究。

受试者

57 例经组织学证实的恶性肝脏肿瘤患者。

磁场强度/序列：在 1.5T 上采集 Gd-EOB-DTPA 给药后 18-20 分钟的低 b 值 DWI，使用 STIR 和 CHESS 序列。

评估

比较 STIR 和 CHESS 序列上肿瘤的对比噪声比（CNR）和肿瘤显影的视觉分级。

统计学检验

采用配对学生 t 检验和 Wilcoxon 符号秩检验。P < 0.05 被认为具有统计学意义。

结果

STIR 上的平均肿瘤 CNR 和肿瘤显影的视觉分级均显著高于 CHESS（均 P < 0.001）。无论是否存在慢性肝病，STIR 上的平均 CNR（正常肝脏 33.5 ± 19.8 比 15.7 ± 12.2，P < 0.001；慢性肝病 19.6 ± 11.0 比 9.2 ± 7.8，P < 0.001）和视觉显影分级（正常肝脏 3.36 ± 0.64 比 2.56 ± 0.77，P < 0.001；慢性肝病 2.94 ± 0.80 比 2.25 ± 0.84，P = 0.001）均显著高于 CHESS。STIR 上的平均 CNR 和视觉显影分级也显著高于 CHESS，用于肝细胞癌（CNR 18.1 ± 10.5 比 8.8 ± 7.2，P < 0.001；视觉分级 2.88 ± 0.83 比 2.22 ± 0.87，P = 0.001）或转移瘤（CNR 35.0 ± 19.3 比 16.2 ± 13.1，P < 0.001；视觉分级 3.45 ± 0.51 比 2.59 ± 0.73，P < 0.001）。