Department of Radiology, Hanyang University Medical Center, Hanyang University School of Medicine, Seoul, Korea.
Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
Korean J Radiol. 2019 Feb;20(2):236-245. doi: 10.3348/kjr.2018.0339.
According to the current guidelines, arterial hyperenhancement for diagnosis of hepatocellular carcinoma (HCC) is determined using the arterial phase only. We investigated the optimal definition of arterial hyperenhancement in patients with HCC using computed tomography (CT) and magnetic resonance imaging (MRI).
The Institutional Review Board approved this retrospective study. The requirement for informed consent was waived. Between January 2011 and September 2013, 147 consecutive patients with surgically proven HCCs with both pre-operative CT and MRI were included. Identification rates of arterial hyperenhancement on CT and magnetic resonance (MR) images using arterial phase only, dual phase (unenhanced and arterial phases), and also subtraction MR images were assessed qualitatively.
The identification rates for arterial hyperenhancement on CT were significantly different between arterial phase and dual phase (72.8% vs. 90.5%; < 0.001), whereas the rates were similar on MRI (91.8% vs. 93.9%; = 0.257). The identification rate of arterial hyperenhancement in MRI increased to 98.6% using subtraction MR images.
Visual comparison of arterial and unenhanced phases could be recommended instead of conventional qualitative arterial phase alone assessment to determine arterial hyperenhancement of HCCs, especially when using CT.
根据现行指南，动脉期强化用于诊断肝细胞癌（HCC）。本研究旨在通过 CT 和 MRI 探讨 HCC 患者动脉期强化的最佳定义。
本研究经机构审查委员会批准（回顾性），豁免知情同意。2011 年 1 月至 2013 年 9 月，连续纳入 147 例经手术证实的 HCC 患者，所有患者均行术前 CT 和 MRI 检查。定性评估动脉期、双期（平扫+动脉期）和减影 MR 图像对 HCC 动脉期强化的检出率。
CT 动脉期和双期的动脉期强化检出率差异有统计学意义（72.8%比 90.5%，<0.001），而 MRI 则无差异（91.8%比 93.9%，=0.257）。减影 MR 图像可将 HCC 动脉期强化的检出率提高至 98.6%。
与传统的仅行动脉期定性评估相比，CT 检查时可推荐行动脉期和实质期的视觉比较来确定 HCC 的动脉期强化，尤其是 CT 检查时。
