Yamashita Y, Mitsuzaki K, Yi T, Ogata I, Nishiharu T, Urata J, Takahashi M
Department of Radiology, Kumamoto University School of Medicine, Japan.
Radiology. 1996 Jul;200(1):79-84. doi: 10.1148/radiology.200.1.8657948.
To compare contrast material-enhanced dynamic magnetic resonance (MR) imaging with helical computed tomography (CT) for the detection of small hepatocellular carcinoma (HCC) in patients with chronic liver damage.
Fifty patients with chronic hepatitis or liver cirrhosis underwent dynamic contrast-enhanced fast low-angle shot MR imaging and multiple-phase helical CT. Arterial, portal-venous, and delayed-phase images were compared. Diagnostic ability with both techniques was evaluated by means of receiver operating characteristic (ROC) analysis; images in patients with (n = 27) and those without (n = 15) HCC in whom the same anatomic levels were available for both examinations were assessed. Seventy-two lesions were evaluated, and tumor diameter ranged from 0.5 to 3.0 cm (mean, 1.9 cm).
ROC analysis showed that the arterial-phase images obtained with both techniques allowed better detection of HCC. Diagnostic ability was significantly better with arterial-phase MR imaging (mean area under the ROC curve [Az] = 0.96) than arterial-phase CT (Az = 0.87) or with images from any other phase (P < .05). For the delayed phase, diagnostic capability was significantly better with CT (Az = 0.84) than with MR imaging (Az = 0.77) (P < .05).
Arterial-phase dynamic MR imaging is superior to helical CT for the detection of HCC in patients with chronic liver damage.
比较对比剂增强动态磁共振（MR）成像与螺旋计算机断层扫描（CT）在检测慢性肝损伤患者小肝细胞癌（HCC）中的应用。
50例慢性肝炎或肝硬化患者接受了动态对比增强快速低角度激发MR成像和多期螺旋CT检查。对动脉期、门静脉期和延迟期图像进行比较。通过接受者操作特征（ROC）分析评估两种技术的诊断能力；对两种检查均有相同解剖层面的有HCC患者（n = 27）和无HCC患者（n = 15）的图像进行评估。共评估72个病灶，肿瘤直径范围为0.5至3.0 cm（平均1.9 cm）。
ROC分析表明，两种技术获得的动脉期图像对HCC的检测效果更好。动脉期MR成像的诊断能力（ROC曲线下平均面积[Az] = 0.96）显著优于动脉期CT（Az = 0.87）或其他任何期相的图像（P < .05）。对于延迟期，CT的诊断能力（Az = 0.84）显著优于MR成像（Az = 0.77）（P < .05）。
在检测慢性肝损伤患者的HCC方面，动脉期动态MR成像优于螺旋CT。
