钆塞酸二钠增强磁共振成像与增强CT在评估肝细胞癌经动脉化疗栓塞术后病变状态的对照研究

A controlled study of Gd-EOB-DTPA-enhanced MRI compared with enhanced CT in assessing lesion status after TACE for hepatocellular carcinoma.

作者信息

Cheng Qichao, Peng Xuewen, Zhou Zhanyu, Wang Bowen, Fan Jinlei, Zuo Liping, Lv Weiwei, Yu Dexin

机构信息

Department of Radiology, Qilu Hospital of Shandong University, Jinan, Shandong, China.

出版信息

Front Med (Lausanne). 2025 Jul 25;12:1602428. doi: 10.3389/fmed.2025.1602428. eCollection 2025.

Abstract

OBJECTIVE

This study aims to evaluate the diagnostic capability of Gd-EOB-DTPA-enhanced MRI in assessing lesion status following transcatheter arterial chemoembolization (TACE) for hepatocellular carcinoma (HCC), in comparison to contrast-enhanced CT (CECT).

METHODS

A total of 56 patients with HCC who underwent Gd-EOB-DTPA-enhanced MRI and CECT scans post-TACE were initially enrolled. The ability of both imaging modalities to differentiate between surviving, new, or necrotic lesions was assessed, using digital subtraction angiography (DSA) or interventional diagnostic results as the reference standard. Detection rates were compared using the chi-square test, while sensitivity, specificity, and accuracy were analyzed with McNemar's test.

RESULTS

After applying inclusion and exclusion criteria, 48 patients were eventually included in the analysis. The reference standard identified 14 cases of surviving lesions, 19 of new lesions, and 15 of necrotic lesions. Gd-EOB-DTPA-enhanced MRI demonstrated a sensitivity of 93.9% (31/33), specificity of 100% (15/15), and a Youden index of 0.939, whereas CECT exhibited a sensitivity of 51.5% (17/33), specificity of 60.0% (9/15), and a Youden index of 0.115.

CONCLUSION

The findings indicate that Gd-EOB-DTPA-enhanced MRI possesses superior diagnostic value for evaluating lesion status in HCC post-TACE compared to CECT, as evidenced by significant differences in sensitivity and specificity ( < 0.05).

摘要

目的

本研究旨在评估钆塞酸二钠增强磁共振成像(Gd-EOB-DTPA-enhanced MRI)在评估肝细胞癌(HCC)经动脉化疗栓塞术(TACE)后病变状态方面的诊断能力,并与对比增强CT(CECT)进行比较。

方法

最初纳入了56例接受TACE后进行Gd-EOB-DTPA增强MRI和CECT扫描的HCC患者。以数字减影血管造影(DSA)或介入诊断结果作为参考标准,评估两种成像方式区分存活、新生或坏死病变的能力。使用卡方检验比较检测率,同时用McNemar检验分析敏感性、特异性和准确性。

结果

应用纳入和排除标准后,最终48例患者纳入分析。参考标准确定了14例存活病变、19例新生病变和15例坏死病变。Gd-EOB-DTPA增强MRI的敏感性为93.9%(31/33),特异性为100%(15/15),约登指数为0.939,而CECT的敏感性为51.5%(17/33),特异性为60.0%(9/15),约登指数为0.115。

结论

研究结果表明,与CECT相比,Gd-EOB-DTPA增强MRI在评估HCC患者TACE术后病变状态方面具有更高的诊断价值,敏感性和特异性存在显著差异(P<0.05)。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/3ba0/12331694/01f2cd4e2298/fmed-12-1602428-g001.jpg

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