Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Republic of Korea; Department of Radiology, Kangbuk Samsung Hospital, Sungkyunkwan University College of Medicine, Republic of Korea.
Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, Republic of Korea.
Eur J Radiol. 2023 Dec;169:111188. doi: 10.1016/j.ejrad.2023.111188. Epub 2023 Nov 5.
To evaluate the added value of threshold growth (TG) for imaging criteria for diagnosing hepatocellular carcinoma (HCC) on gadoxetic acid-enhanced MRI.
Patients who underwent preoperative gadoxetic acid-enhanced MRI because of absence of 'definite HCC' (Liver Imaging Reporting and Data System category 5) on prior CT or MRI between January 2016 and December 2020 were retrospectively analyzed. The sensitivity and specificity for 'definite HCC' according to the criteria of the European Association for the Study of the Liver [EASL], Asian Pacific Association for the Study of the Liver [APASL], and Korean Liver Cancer Association-National Cancer Center [KLCA-NCC] were separately calculated with and without TG as a major imaging feature. The results were compared using generalized estimating equations.
Of 202 nodules in 154 patients, 19 % showed TG. When TG was used as a major imaging feature, the sensitivity of EASL were significantly higher than when it was not used (59.2 % vs. 51.4 %, p = 0.001), whereas the sensitivities of APASL and KLCA-NCC did not significantly differ. No significant difference was found in the specificities of the three imaging criteria when TG was used or not (p ≥ 0.16). Of 11 HCCs additionally detected when TG was added to EASL criteria, 9 showed transitional-phase or hepatobiliary-phase hypointensity without portal venous-phase washout.
TG had added value for improving the sensitivity of EASL criteria for gadoxetic acid-enhanced MRI without extending washout to transitional-phase or hepatobiliary-phase images.
评估门冬氨酸增强 MRI 成像标准中阈值生长（TG）对肝细胞癌（HCC）诊断的附加价值。
回顾性分析了 2016 年 1 月至 2020 年 12 月期间因 CT 或 MRI 上无“明确 HCC”（Liver Imaging Reporting and Data System 类别 5）而接受术前门冬氨酸增强 MRI 的患者。分别计算了 EASL、APASL 和 KLCA-NCC 标准中有无 TG 作为主要成像特征时，对“明确 HCC”的敏感性和特异性。使用广义估计方程比较结果。
在 154 例患者的 202 个结节中，19%显示 TG。当 TG 作为主要成像特征时，EASL 的敏感性显著高于不使用 TG 时（59.2%比 51.4%，p=0.001），而 APASL 和 KLCA-NCC 的敏感性无显著差异。使用或不使用 TG 时，三种成像标准的特异性无显著差异（p≥0.16）。当将 TG 添加到 EASL 标准中时，另外检测到 11 个 HCC，其中 9 个在门脉期洗脱后无过渡期或肝胆期低信号。
TG 可提高 EASL 标准对门冬氨酸增强 MRI 的敏感性，而不会将洗脱扩展到过渡期或肝胆期图像，具有附加价值。
