Li Jiangfa, Li Xiaoqing, Weng Jun, Lei Liping, Gong Jianhua, Wang Junyi, Li Zhenghang, Zhang Longmiao, He Songqing
Department of Hepatobiliary and Pancreatic Surgery, The First Affiliated Hospital of Guangxi Medical University, Nanning 530021, China.
Department of Hepatobiliary and Pancreatic Surgery, Affiliated Hospital of Guilin Medical University, Guilin 541001, China.
Medicine (Baltimore). 2018 Dec;97(52):e13964. doi: 10.1097/MD.0000000000013964.
This study aimed to compare the sensitivity and accuracy for the detection of small lesions in patients with hepatocellular carcinoma (HCC) using gadolinium-ethoxybenzyl-diethylenetriamine pentaacetic acid (Gd-EOB-DTPA) dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) and 64-slice computed tomography (CT) enhanced scanning, and to evaluate the necessity to perform MRI in patients diagnosed with HCC by CT.The clinical data from 209 patients with HCC diagnosed prior to surgery in the Affiliated Hospital of Guilin Medical University, China were retrospectively analyzed. The 64-slice dynamic contrast-enhanced multi-detector CT (MDCT) and 3.0 T Gd-EOB-DTPA DCE MRI procedures were successively carried out on all patients who were enrolled in a self-controlled study including detection and diagnosis of HCC lesions by MRI and CT, respectively.A total of 243 lesions were detected and both imaging methods could accurately detect lesions of diameter >2 cm. For lesions <2 cm, MRI detected 47, while CT detected 25 lesions indicating that the detection rate of MRI was 88% higher than that of CT. In addition, MRI detected lesions in 15 cases (7.81% in the total of 209 cases) that were not diagnosed by CT. Among these cases, 2 patients were diagnosed to have no lesion by CT.Gd-EOB-DTPA DCE-MRI performed as a routine check prior to surgery in HCC patients can improve the detection of small HCC lesions.
本研究旨在比较钆塞酸二钠(Gd-EOB-DTPA)动态对比增强磁共振成像(DCE-MRI)与64层计算机断层扫描(CT)增强扫描检测肝细胞癌(HCC)患者小病灶的敏感性和准确性,并评估CT诊断为HCC的患者进行MRI检查的必要性。回顾性分析了中国桂林医学院附属医院209例术前诊断为HCC患者的临床资料。对所有纳入自身对照研究的患者依次进行64层动态对比增强多排CT(MDCT)和3.0 T Gd-EOB-DTPA DCE MRI检查,分别通过MRI和CT检测及诊断HCC病灶。共检测到243个病灶,两种成像方法均能准确检测出直径>2 cm的病灶。对于<2 cm的病灶,MRI检测到47个,而CT检测到25个病灶,表明MRI的检测率比CT高88%。此外,MRI检测到15例(占209例总数的7.81%)CT未诊断出的病灶。在这些病例中,2例患者CT诊断无病灶。术前将Gd-EOB-DTPA DCE-MRI作为HCC患者的常规检查可提高小HCC病灶的检出率。