Discipline of Diagnostic Radiography, University of Sydney, Sydney, Australia.
J Clin Ultrasound. 2022 Jul;50(6):862-868. doi: 10.1002/jcu.23197. Epub 2022 Mar 26.
The dual-energy computed tomography (DECT) and diffusion-weighted magnetic resonance imaging (DWI-MRI) are used to diagnose liver cancer. The clinical value of these two examination methods needs to be further summarized. We collected and summarized relevant literature published from 2011 to 2021. The diagnostic performance of DECT was assessed between conventional computed tomography and DWI-MRI. DWI-MRI had a 69% sensitivity for detecting small hepatocellular carcinoma (HCC) lesions and a 60% diagnostic specificity for differentiating between types of HCC lesions. DECT had a sensitivity to small liver lesions (<1 cm) of 69%, and the diagnostic specificity for HCC and metastasis was about 60%. DWI was more sensitive (90.3% vs. 74.9%) and accurate (91.9% vs. 76.9%) in diagnosing HCC compared with conventional MRI sequencing. With the aid of contrast media, DWI-MRI had 90.0% specificity for detecting small HCCs (smaller than 1 cm). Furthermore, DWI-MRI not only provided physicians with valuable diagnostic information but also delivered histological grading information, with 78% accuracy for all benign lesions and 71% for solid lesions. DECT had relatively high sensitivity and required a lower contrast medium dose. With standardized quantitative parameters, it can be an extremely useful tool for HCC surveillance. DWI-MRI is the preferred imaging process as it produces high-contrast images for supporting an early diagnosis (high sensitivity and specificity) and provides histological information using non-ionizing radiation.
双能 CT(DECT)和弥散加权磁共振成像(DWI-MRI)用于诊断肝癌。这两种检查方法的临床价值有待进一步总结。我们收集并总结了 2011 年至 2021 年发表的相关文献。评估了 DECT 与常规 CT 和 DWI-MRI 之间的诊断性能。DWI-MRI 对小肝细胞癌(HCC)病变的检出率为 69%,对 HCC 病变类型的鉴别诊断特异性为 60%。DECT 对小肝病变(<1cm)的检出率为 69%,对 HCC 和转移的诊断特异性约为 60%。与常规 MRI 序列相比,DWI 对 HCC 的诊断更敏感(90.3% vs. 74.9%)和准确(91.9% vs. 76.9%)。在辅助对比剂的情况下,DWI-MRI 对小 HCC(<1cm)的特异性为 90.0%。此外,DWI-MRI 不仅为医生提供了有价值的诊断信息,还提供了组织学分级信息,对所有良性病变的准确率为 78%,对实性病变的准确率为 71%。DECT 具有相对较高的敏感性,所需对比剂剂量较低。通过标准化的定量参数,它可以成为 HCC 监测的非常有用的工具。DWI-MRI 是首选的成像过程,因为它可以产生高对比度的图像,支持早期诊断(高敏感性和特异性),并使用非电离辐射提供组织学信息。