使用 Gd-EOB-DTPA 对肝细胞腺瘤进行亚型分类：定性和定量分析。

Subtyping of hepatocellular adenomas using Gd-EOB-DTPA: a qualitative and quantitative analysis.

机构信息

Conradia, Diagnostic Imaging and Prevention Center, Munich, Germany.

Department of Radiology, University Medical Center Brandenburg an der Havel, Brandenburg, Germany.

出版信息

Acta Radiol. 2023 Jul;64(7):2253-2260. doi: 10.1177/02841851221149197. Epub 2023 Jan 17.

DOI:10.1177/02841851221149197

PMID:36650712

Abstract

BACKGROUND

The goal of medical imaging is not only to identify the entity "hepatocellular adenoma," but to detect typical magnetic resonance (MR) patterns of the subtypes so that lesions with a higher malignant transformation rate could be differentiated from those that should just be controlled.

PURPOSE

To evaluate the differentiation between subtypes of hepatocellular adenomas using hepatobiliary specific contrast agent (Gd-EOB-DTPA) in MR imaging.

MATERIAL/METHODS: A total of 11 patients with 39 lesions with histologically proven hepatocellular adenomas were evaluated. Of the, 34 were inflammatory hepatocellular adenomas (IHCA) and 5 were HNF1α adenomas. No β-catenin-mutated adenoma was found. In all patients, a standard protocol considering the guidelines of the international consensus conference of Gd-EOB-DTPA was performed in a 1.5-T scanner. Besides a qualitative analysis of all sequences, we measured the quantitative signal intensity (SI) ratio in all examinations.

RESULTS

Qualitative analysis showed that best sequences for differentiation of HNF1α adenomas from IHCA were T1-weighted (T1W) precontrast ( = 0.03) and portalvenous phase ( < 0.0001) as well as arterial phase ( = 0.002). All adenomas were hypointense in hepatobiliary phase (15 min). The quantitative analyses of the SI ratio and of lesion-to-liver contrast (LLC) ratio show statistically significant differences in T1W precontrast (SI: = 0.035; LLC: = 0.049) and portalvenous phase (SI: = 0.002; LLC: = 0.002).

CONCLUSION

Subtyping of hepatocellular adenomas using Gd-EOB-DTPA is possible due to qualitative and quantitative analyses regarding T1W precontrast and portalvenous phase. In addition, the SI ratio and liver-to-lesion contrast ratio in the arterial phase gave additional qualitative information for differentiation.

摘要

背景

医学影像学的目标不仅是识别“肝细胞腺瘤”实体，还要检测其亚型的典型磁共振（MR）模式，以便将恶性转化率较高的病变与只需控制的病变区分开来。

目的

用肝胆特异性对比剂（钆塞酸二钠）在 MR 成像中评估肝细胞腺瘤亚型的区分。

材料/方法：对 11 例经组织学证实的 39 个肝细胞腺瘤患者进行评估。其中 34 例为炎症性肝细胞腺瘤（IHCA），5 例为 HNF1α 腺瘤。未发现β-连环蛋白突变腺瘤。在所有患者中，在 1.5-T 扫描仪上进行了考虑国际共识会议指南的标准方案。除了对所有序列进行定性分析外，我们还测量了所有检查的定量信号强度（SI）比值。

结果

定性分析表明，区分 HNF1α 腺瘤与 IHCA 的最佳序列为 T1 加权（T1W）平扫（ = 0.03）和门静脉期（ < 0.0001）以及动脉期（ = 0.002）。所有腺瘤在肝胆期（15 分钟）均呈低信号。SI 比值和病变与肝脏对比度（LLC）比值的定量分析显示，在 T1W 平扫（SI： = 0.035；LLC： = 0.049）和门静脉期（SI： = 0.002；LLC： = 0.002）具有统计学差异。