Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
Eur J Radiol. 2021 Feb;135:109474. doi: 10.1016/j.ejrad.2020.109474. Epub 2020 Dec 13.
To investigate the imaging features of gadoxetic acid-enhanced magnetic resonance imaging (MRI) to differentiate hepatic sclerosing hemangioma from malignant tumors.
This retrospective case-control study included 18 patients with sclerosing hemangioma and 54 patients with common hepatic malignant tumor, including hepatocellular carcinoma, metastatic adenocarcinoma, and cholangiocarcinoma, who were examined using gadoxetic acid-enhanced liver MRI from January 2008 to June 2019. Imaging features including signal intensity, tumor margins, enhancement pattern, and presence or absence of diffusion restriction were analyzed. Significant MRI features for predicting sclerosing hemangioma were identified using multivariable logistic regression analysis. Diagnostic performances of each imaging feature and combinations of significant imaging features were summarized.
In the multivariable analysis, irregular margins (odds ratio [OR], 10.12; 95 % confidence interval [CI], 1.27-80.94; p = 0.029), centripetal or internal nodular enhancement in the transitional phase (OR, 13.58; 95 % CI, 1.48-124.82; p = 0.021), and absence of diffusion restriction (OR, 39.20; 95 % CI, 4.82-318.49; p = 0.001) were significant imaging features for the diagnosis of sclerosing hemangioma. Presence of at least two significant imaging features had a sensitivity, specificity, and accuracy of 88.9 %, 96.3 %, and 94.4 %, respectively, for diagnosing sclerosing hemangioma.
Combinations of two or more of the significant imaging features (irregular margins, centripetal or internal nodular enhancement in the transitional phase, and absence of diffusion restriction) were effective for differentiating hepatic sclerosing hemangioma from malignant tumors using gadoxetic acid-enhanced MRI.
探讨钆塞酸增强磁共振成像（MRI）的影像学特征，以鉴别肝硬化性血管瘤与恶性肿瘤。
本回顾性病例对照研究纳入了 2008 年 1 月至 2019 年 6 月期间接受钆塞酸增强肝脏 MRI 检查的 18 例硬化性血管瘤患者和 54 例常见肝恶性肿瘤患者，包括肝细胞癌、转移性腺癌和胆管细胞癌。分析了信号强度、肿瘤边缘、强化模式以及是否存在弥散受限等影像学特征。采用多变量逻辑回归分析确定预测硬化性血管瘤的显著 MRI 特征。总结了每个影像学特征及其显著影像学特征组合的诊断性能。
多变量分析显示，不规则边缘（比值比 [OR]，10.12；95%置信区间 [CI]，1.27-80.94；p = 0.029）、过渡期中心性或内部结节样强化（OR，13.58；95%CI，1.48-124.82；p = 0.021）和不存在弥散受限（OR，39.20；95%CI，4.82-318.49；p = 0.001）是诊断硬化性血管瘤的显著影像学特征。至少存在两个显著影像学特征时，诊断硬化性血管瘤的敏感性、特异性和准确性分别为 88.9%、96.3%和 94.4%。
使用钆塞酸增强 MRI，联合两个或多个显著影像学特征（不规则边缘、过渡期中心性或内部结节样强化和不存在弥散受限）可有效鉴别肝硬化性血管瘤与恶性肿瘤。
