Soyer P, Levesque M, Caudron C, Elias D, Zeitoun G, Roche A
Department of Radiology, Hôpital Louis Mourier, Colombes, France.
J Comput Assist Tomogr. 1993 Jan-Feb;17(1):67-74. doi: 10.1097/00004728-199301000-00012.
A prospective study was performed to compare, with a lesion-by-lesion analysis, the sensitivities of high field strength MRI and CT during arterial portography (CTAP) in detecting hepatic metastases from colorectal cancer. Twenty-one patients with liver metastases from colorectal cancer were prospectively investigated by high field strength MRI (1.5 or 2 T) and CTAP. High field strength MRI was performed with pre and post gadopentetate dimeglumine enhanced T1-weighted SE sequences and T2-weighted SE sequences. All patients underwent partial hepatectomy and 37 metastases were surgically and pathologically proved. The metastasis detection rate (sensitivity) was 94% (35 of 37) for CTAP and 78% (29 of 37) for high field strength MRI. The 16% (95% confidence interval: 1-31%) difference in sensitivity between CTAP and high field strength MRI was statistically significant (p < 0.05, McNemar test). The use of gadopentetate dimeglumine did not improve the sensitivity of T1-weighted SE sequences. Since our study demonstrated significant difference in sensitivities between high field strength MRI and CTAP in our group of patients, we can conclude that high field strength MRI cannot replace CTAP in the preoperative evaluation of patients with liver metastases from colorectal cancer. Computed tomography during arterial portography must be considered as the preoperative gold standard.
进行了一项前瞻性研究，通过逐病灶分析比较高场强磁共振成像（MRI）和动脉门静脉造影（CTAP）期间CT在检测结直肠癌肝转移方面的敏感性。对21例结直肠癌肝转移患者进行了高场强MRI（1.5或2T）和CTAP前瞻性研究。高场强MRI采用钆喷酸葡胺增强前后的T1加权SE序列和T2加权SE序列进行。所有患者均接受了肝部分切除术，37处转移灶经手术和病理证实。CTAP的转移灶检出率（敏感性）为94%（37处中的35处），高场强MRI为78%（37处中的29处）。CTAP与高场强MRI之间16%（95%置信区间：1-31%）的敏感性差异具有统计学意义（p<0.05，McNemar检验）。使用钆喷酸葡胺并未提高T1加权SE序列的敏感性。由于我们的研究表明在我们的患者组中高场强MRI与CTAP之间的敏感性存在显著差异，我们可以得出结论，在结直肠癌肝转移患者的术前评估中，高场强MRI不能替代CTAP。动脉门静脉造影期间的计算机断层扫描必须被视为术前金标准。
