Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Republic of Korea.
Department of Radiology, Ajou University School of Medicine, Suwon, Korea.
J Magn Reson Imaging. 2023 Mar;57(3):941-949. doi: 10.1002/jmri.28357. Epub 2022 Jul 18.
The visualization score of hepatobiliary-phase (HBP) images has been introduced as an image quality index for gadoxetic acid-enhanced MRI. It may be associated with hepatic function and could have an implication on the diagnostic accuracy for hepatocellular carcinoma (HCC).
To investigate the association between the visualization score of gadoxetic acid-enhanced MRI and clinical factors and to evaluate its effect on the diagnostic accuracy for HCC ≤ 3.0 cm.
Retrospective.
A total of 493 focal lesions from 397 patients.
FIELD STRENGTH/SEQUENCE: A 5-T or 3.0 -T with pre/postcontrast T1-weighted 3D gradient echo sequence, and T2-weighted fast spin-echo sequence ASSESSMENT: Child-Pugh classification and albumin-bilirubin (ALBI) score were assessed. Three readers evaluated the visualization score of each MRI examination (A, no or minimal; B, moderate; and C, severe limitations), and major features (arterial-phase hyperenhancement, washout, enhancing capsule, threshold growth) and ancillary features of each focal lesion.
Univariable and multivariable logistic regression analyses were performed to determine significant clinical factors associated with a suboptimal visualization score (B or C). Generalized estimating equations were used to compare the sensitivity and specificity for diagnosing HCC between the two group (visualization score A vs. B or C). A P value < 0.05 was considered statistically significant.
Of the 397 MRI examinations, the incidence of suboptimal visualization score was 13%. A suboptimal visualization score was significantly associated with Child-Pugh classification B or C (adjusted odds ratio [OR] = 15.2) and ALBI grade 2 or 3 (OR = 4.7). Compared with the visualization score A group, the suboptimal visualization score group showed significantly lower sensitivity (56.8% vs. 75.2%) and less frequent washout in HCC (62.2% vs. 84.0%).
The visualization score on gadoxetic acid-enhanced MRI can be an important image quality index and the diagnostic accuracy for HCC ≤ 3.0 cm may not be sufficient in the suboptimal visualization score group.
3 TECHNICAL EFFICACY STAGE: 3.
肝胆期（HBP）图像的可视化评分已被引入作为钆塞酸增强 MRI 的图像质量指数。它可能与肝功能有关，并可能对肝细胞癌（HCC）的诊断准确性有影响。
探讨钆塞酸增强 MRI 可视化评分与临床因素的相关性，并评估其对诊断≤3.0cm HCC 的准确性的影响。
回顾性。
共 397 例患者的 493 个局灶性病变。
磁场强度/序列：5T 或 3.0T，采用对比前后 T1 加权 3D 梯度回波序列和 T2 加权快速自旋回波序列。
Child-Pugh 分级和白蛋白-胆红素（ALBI）评分。三位读者评估了每次 MRI 检查的可视化评分（A，无或轻微；B，中度；C，严重受限），以及每个局灶性病变的主要特征（动脉期高增强、洗脱、增强包膜、阈值生长）和辅助特征。
采用单变量和多变量逻辑回归分析确定与次优可视化评分（B 或 C）相关的显著临床因素。使用广义估计方程比较两组之间诊断 HCC 的敏感性和特异性（可视化评分 A 与 B 或 C）。P 值<0.05 被认为具有统计学意义。
在 397 次 MRI 检查中，次优可视化评分的发生率为 13%。次优可视化评分与 Child-Pugh 分级 B 或 C（调整后比值比 [OR] = 15.2）和 ALBI 分级 2 或 3（OR = 4.7）显著相关。与可视化评分 A 组相比，次优可视化评分组 HCC 的敏感性明显较低（56.8% vs. 75.2%），洗脱频率较低（62.2% vs. 84.0%）。
钆塞酸增强 MRI 的可视化评分可以作为一个重要的图像质量指数，而在次优可视化评分组中，诊断≤3.0cm HCC 的准确性可能不足。
3 技术功效分期：3
