Kuwata Y, Hirota S, Sugimoto K, Koshino T, Nishida Y, Tomita M, Matsumoto S, Sako M, Kono M
Dept. of Radiology, Kobe University School of Medicine.
Gan To Kagaku Ryoho. 1994 Jul;21(8):1235-40.
We evaluated re-diagnostic ability of dynamic MRI as compared with T2 weighted image in the diagnosis of primary therapeutic effect and tumor recurrence after transcatheter arterial embolization (TAE) for hepatocellular carcinoma. Thirty-four nodules in 30 patients with hepatocellular carcinoma were estimated based on operative and angiographic findings. According to the time when dynamic MRI was taken, nodules were classified as a short-term observation group consisting of 15 nodules obtained within a month after TAE, or as a long-term observation group consisting of 19 nodules obtained over a month after TAE. In the short-term observation group, sensitivity, specificity, accuracy was 89%, 100%, 93% on dynamic MRI and 78%, 67%, 73% on T2WI, respectively. In the long-term observation group, these were 94%, 100%, 95% on dynamic MRI and 100%, 33%, 89% on T2WI and 94%, 67%, 89% on Lipiodol-CT, respectively. In both groups, dynamic MRI was superior in accuracy. Conclusively, we consider that dynamic MRI is a most accurate diagnostic method that should be added to routine MRI after TAE. Especially in the case diagnosed positive on T2WI, the usefulness of dynamic MRI should be emphasized to determine the schedule of the therapy, because the cases that were false positive on T2WI were accurately diagnosed on dynamic MRI.
我们评估了动态磁共振成像（MRI）与T2加权图像相比，在经导管动脉栓塞术（TAE）治疗肝细胞癌后原发性治疗效果及肿瘤复发诊断中的再诊断能力。根据手术和血管造影结果对30例肝细胞癌患者的34个结节进行评估。根据动态MRI检查时间，结节被分为短期观察组（由TAE术后1个月内获得的15个结节组成）或长期观察组（由TAE术后1个月后获得的19个结节组成）。在短期观察组中，动态MRI的敏感性、特异性、准确性分别为89%、100%、93%，T2加权成像（T2WI）分别为78%、67%、73%。在长期观察组中，动态MRI的敏感性、特异性、准确性分别为94%、100%、95%，T2WI分别为100%、33%、89%，碘油CT分别为94%、67%、89%。在两组中，动态MRI的准确性更高。总之，我们认为动态MRI是一种最准确的诊断方法，应在TAE术后添加到常规MRI检查中。特别是在T2WI诊断为阳性的情况下，应强调动态MRI在确定治疗方案中的有用性，因为T2WI上假阳性的病例在动态MRI上能得到准确诊断。
