Moosavi Bardia, Shenoy-Bhangle Anuradha S, Tsai Leo L, Reuf Robert, Mortele Koenraad J
Department of Radiology, Hull Hospital, Gatineau, Quebec, J8Y1W7, Canada.
Division of Abdominal Imaging, Department of Radiology, Beth Israel Deaconess Medical Center, Harvard Medical School, 330 Brookline Ave, Boston, MA, 02215, USA.
Insights Imaging. 2020 Sep 22;11(1):101. doi: 10.1186/s13244-020-00894-3.
To evaluate the added value of the hepatobiliary (HPB) phase in gadoxetic acid-enhanced magnetic resonance imaging (MRI) in characterizing newly discovered indeterminate focal liver lesions in non-cirrhotic patients.
One-hundred and twenty-five non-cirrhotic patients (median age, 46 years; range, 20-85 years; 100 females) underwent gadoxetic acid-enhanced MRI, including the 20-min delayed HPB phase, for characterization of newly discovered focal liver lesions. Images were independently evaluated by two blinded, board-certified abdominal radiologists (R1 and R2) who characterized liver lesions without and with assessment of the HPB phase images in two separate readout sessions. Confidence in diagnosis was scored on a scale from 0 to 3. Inter-observer agreement was assessed using Cohen κ statistics. Change in diagnosis and confidence in diagnosis were evaluated by Wilcoxon signed rank test. There was no significant change in diagnosis before and after evaluation of the HPB phase for both readers (p = 1.0 for R1; p = 0.34 for R2). Confidence in diagnosis decreased from average 2.8 ± 0.45 to 2.6 ± 0.59 for R1 and increased from 2.6 ± 0.83 to 2.8 ± 0.46 for R2. Change in confidence was only statistically significant for R1 (p = 0.003) but not significant for R2 (p = 0.49). Inter-reader agreement in diagnosis was good without (k = 0.66) and with (k = 0.75) inclusion of the HPB phase images.
The added information obtained from the HPB phase of gadoxetic acid-enhanced MRI does not change the diagnosis or increase confidence in diagnosis when evaluating new indeterminate focal liver lesions in non-cirrhotic patients.
评估钆塞酸增强磁共振成像（MRI）的肝胆（HPB）期在非肝硬化患者新发现的不确定局灶性肝病变特征性诊断中的附加价值。
125例非肝硬化患者（中位年龄46岁；范围20 - 85岁；100例女性）接受了钆塞酸增强MRI检查，包括20分钟延迟的HPB期，以对新发现的局灶性肝病变进行特征性诊断。图像由两名不知情的、获得委员会认证的腹部放射科医生（R1和R2）独立评估，他们在两个单独的读片环节中分别在不考虑和考虑HPB期图像的情况下对肝病变进行特征性诊断。诊断信心按0至3分进行评分。观察者间一致性采用Cohen κ统计量进行评估。诊断变化和诊断信心变化采用Wilcoxon符号秩检验进行评估。对于两位读者，在评估HPB期前后诊断均无显著变化（R1，p = 1.0；R2，p = 0.34）。R1的诊断信心从平均2.8±0.45降至2.6±0.59，R2的诊断信心从2.6±0.83升至2.8±0.46。信心变化仅对R1有统计学意义（p = 0.003），对R2无统计学意义（p = 0.49）。纳入HPB期图像前后读者间诊断一致性良好（不纳入时κ = 0.66，纳入时κ = 0.75）。
在评估非肝硬化患者新发现的不确定局灶性肝病变时，钆塞酸增强MRI的HPB期所获得的附加信息不会改变诊断，也不会增加诊断信心。
