Department of Radiology and Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, Seoul, 05505, South Korea.
Department of Radiology, Kangdong Seong-Sim Hospital, Hallym University College of Medicine, Seoul, South Korea.
Abdom Radiol (NY). 2022 Mar;47(3):1024-1031. doi: 10.1007/s00261-021-03403-2. Epub 2022 Jan 12.
We aimed to determine the optimal image sequence for measurement of hepatic observations on gadoxetate disodium-enhanced MRI in comparison with pathologic measurement, and to evaluate its clinical impact on the Liver Imaging Reporting and Data System (LI-RADS) v2018 classification.
Two hundred and fifty-three patients (279 hepatic observations) who underwent gadoxetate disodium-enhanced MRI and subsequent hepatectomy were retrospectively included. Two radiologists independently evaluated the visualization score (five-point scale) and size of each observation on six MRI sequences (T1-weighted, T2-weighted, arterial-phase, portal venous-phase, transitional-phase [TP], and hepatobiliary-phase [HBP] images) and assigned a LI-RADS category. Correlations between MRI and pathologic measurements were evaluated using Pearson correlation coefficients. A repeated measures analysis of variance with Bonferroni post hoc comparison tests was used to compare the visualization scores and absolute differences between MRI sequences and pathologic measurements. The LI-RADS classification according the size measurement of each MRI sequence was compared using Cochran's Q test with a post hoc McNemar's test.
Of the MRI sequences, HBP had the highest visualization score (4.1 ± 0.6) and correlation coefficient (r = 0.965). The absolute difference between MRI and pathologic measurement was lowest on TP (2.3 mm ± 2.2), followed by HBP (2.4 mm ± 2.1). In the LI-RADS classifications, HBP did not have any non-visible observations. Regarding LR-3, LR-4, and LR-5, there was no significantly different LI-RADS classification among the six MRI sequences (p ≥ 0.122).
Hepatobiliary-phase images are clinically useful for measuring hepatic observations on gadoxetate disodium-enhanced MRI, especially regarding visibility and correlation with pathologic findings.
本研究旨在确定钆塞酸二钠增强 MRI 上肝脏观察的最佳图像序列，以与病理测量进行比较，并评估其对肝脏影像报告和数据系统（LI-RADS）v2018 分类的临床影响。
回顾性纳入 253 例（279 个肝脏观察）接受钆塞酸二钠增强 MRI 检查并随后接受肝切除术的患者。两位放射科医生分别对六组 MRI 序列（T1 加权像、T2 加权像、动脉期、门静脉期、过渡期 [TP] 和肝胆期 [HBP] 图像）上的每个观察进行可视化评分（五分制）和大小评估，并对 LI-RADS 类别进行赋值。采用 Pearson 相关系数评估 MRI 与病理测量之间的相关性。采用重复测量方差分析和 Bonferroni 事后比较检验比较 MRI 序列与病理测量之间的可视化评分和绝对差异。采用 Cochran's Q 检验和事后 McNemar 检验比较各 MRI 序列大小测量的 LI-RADS 分类。
在 MRI 序列中，HBP 的可视化评分（4.1±0.6）和相关系数（r=0.965）最高。TP（2.3mm±2.2）的 MRI 与病理测量的绝对差值最小，其次是 HBP（2.4mm±2.1）。在 LI-RADS 分类中，HBP 没有不可见的观察。在 LR-3、LR-4 和 LR-5 中，六组 MRI 序列之间的 LI-RADS 分类无显著差异（p≥0.122）。
肝胆期图像对测量钆塞酸二钠增强 MRI 上的肝脏观察具有临床意义，特别是在可见性和与病理发现的相关性方面。
