Department of Diagnostic Radiology, Saitama Medical University International Medical Center, 350-1298, Yamane 1397-1, Hidaka, Saitama, Japan; Department of Radiology, University of Yamanashi, 409-3898, Shimokato, Chuo, Yamanashi, Japan.
Department of Diagnostic Radiology, Saitama Medical University International Medical Center, 350-1298, Yamane 1397-1, Hidaka, Saitama, Japan.
Eur J Radiol. 2021 May;138:109620. doi: 10.1016/j.ejrad.2021.109620. Epub 2021 Mar 1.
To compare the estimated quantity of intratumor gadoxetic acid retention using T1 mapping of gadoxetic acid-enhanced magnetic resonance imaging (MRI) versus conventional processing methods for the differential diagnosis of focal liver lesions.
Seventy patients with hepatic lesions (colorectal metastasis (CRM) [n = 28], hepatocellular carcinoma (HCC) [n = 20], hemangioma [n = 12], and intrahepatic cholangiocarcinoma (ICC) [n = 10]) underwent gadoxetic acid-enhanced MRI, including pre- and post-contrast T1-weighted imaging and T1 mapping. Quantitative analyses included the lesion-to-liver signal intensity ratio (SIR) on hepatobiliary phase images, the pre- and post-contrast lesion T1 value difference (ΔT1 [ms]), and the lesion retention index (LRI [%]), which was the estimated intralesional gadoxetic acid retention calculated on pre- and post-contrast T1 maps using a two-compartment pharmacokinetic model. Results were compared between the four subcategories of focal liver lesions using the Kruskal-Wallis test, followed by the post-hoc Dunn's test and receiver operating characteristic (ROC) analysis to distinguish between pairs of the four lesion subcategories.
This study identified significant differences in the LRI of the four lesion subcategories (p < 0.01), without significant differences in ΔT1 or SIR. Post-hoc analysis demonstrated significant differences in CRM vs. hemangioma (p < 0.01), hemangioma vs. ICC (p < 0.01), and HCC vs. ICC (p = 0.047) for the LRI.
The quantity of intratumor gadoxetic acid retention estimated using pre- and post- contrast T1 mapping could distinguish focal liver lesions, unlike conventional processing methods, and captured unique lesion characteristics.
比较使用钆塞酸增强磁共振成像（MRI）T1 映射估计肿瘤内钆塞酸保留量与常规处理方法在鉴别局灶性肝病变中的差异。
70 例肝脏病变患者（结直肠癌转移瘤[CRM] [n=28]、肝细胞癌[HCC] [n=20]、血管瘤[n=12]和肝内胆管细胞癌[ICC] [n=10]）接受了钆塞酸增强 MRI 检查，包括对比前和对比后 T1 加权成像和 T1 映射。定量分析包括肝胆期图像上的病变与肝脏信号强度比（SIR）、对比前后病变 T1 值差异（ΔT1 [ms]）和病变保留指数（LRI [%]），后者是使用双室药代动力学模型在对比前和对比后 T1 图上估计的肿瘤内钆塞酸保留量。使用 Kruskal-Wallis 检验比较四种局灶性肝病变的亚类之间的结果，然后进行事后 Dunn 检验和受试者工作特征（ROC）分析以区分四种病变亚类的两对。
本研究发现四种病变亚类的 LRI 存在显著差异（p<0.01），而 ΔT1 或 SIR 无显著差异。事后分析显示 CRM 与血管瘤（p<0.01）、血管瘤与 ICC（p<0.01）以及 HCC 与 ICC（p=0.047）之间的 LRI 存在显著差异。
使用对比前和对比后 T1 映射估计肿瘤内钆塞酸保留量可以区分局灶性肝病变，与常规处理方法不同，并且可以捕获独特的病变特征。
