非对比MRI和使用gadoxetic acid的缩写MRI在最初诊断的肝细胞癌患者中的诊断性能比较：对肝细胞癌监视的模拟研究。,European Radiology

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非对比MRI和使用gadoxetic acid的缩写MRI在最初诊断的肝细胞癌患者中的诊断性能比较：对肝细胞癌监视的模拟研究。
European Radiology ( IF 4.7 ) Pub Date : 2020-03-12 , DOI: 10.1007/s00330-020-06754-4
Sunyoung Whang ₁ , Moon Hyung Choi _{2,

3} , Joon-Il Choi _{1,

2} , Seo Yeon Youn ₁ , Dong Hwan Kim ₁ , Sung Eun Rha ₁

Affiliation

目的进行本研究的目的是为了比较使用造影剂对初诊HCC患者进行肝细胞癌（HCC）的非对比和缩写MRI的诊断性能。方法我们确定了米兰标准范围内的140例新诊断为HCC的连续患者（173例HCC），这些患者在2015年至2016年期间使用了鹿角酸进行了肝脏MRI检查。123例无HCC的连续患者同时在同期进行了肝脏MRI检查监测参加了对照组。两名放射科医生独立检查了两个MRI装置：非对比装置和缩写装置。非对比集由T2 FSE / ssFSE，T1同相和异相图像，DWI和ADC映射组成。缩写集由T2 FSE / ssFSE，葡萄糖酸注射后20分钟的肝胆期图像，DWI和ADC图。结果在每位患者的分析中，审阅者1对非对比和缩写集的敏感性分别为85.7％和90.0％。非对比和缩写集的特异性均为92.7％。对于审阅者2，非对比和缩写集的敏感性分别为86.4％和89.3％。对于非对比组和缩写组，审阅者2的每位患者特异性均为92.7％。两位评价者的两个图像集的敏感性和特异性无显着差异。审稿人1的非对比和缩写集的每肿瘤敏感性分别为81.5％和84.4％，审稿人2的分别为79.8和84.4％。没有显着差异。结论使用造影剂的非对比MRI和缩写MRI在早期诊断HCC患者中表现出可比的诊断性能。要点•在早期肝癌患者中，使用伽多辛酸进行非对比MRI和缩写MRI的诊断性能可与HCC媲美。•非对比MRI和缩写MRI在早期检测HCC方面显示出高灵敏度和特异性。•通过采用这些简化且集中的MRI方案，可以改善高危患者HCC的监测结果。•非对比MRI和缩写MRI在早期检测HCC方面显示出高灵敏度和特异性。•通过采用这些简化且集中的MRI方案，可以改善高危患者HCC的监测结果。•非对比MRI和缩写MRI在早期检测HCC方面显示出高灵敏度和特异性。•通过采用这些简化且集中的MRI方案，可以改善高危患者HCC的监测结果。

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Comparison of diagnostic performance of non-contrast MRI and abbreviated MRI using gadoxetic acid in initially diagnosed hepatocellular carcinoma patients: a simulation study of surveillance for hepatocellular carcinomas.

OBJECTIVE This study was conducted in order to compare the diagnostic performance of noncontrast and abbreviated MRI using gadoxetic acid for detecting hepatocellular carcinoma (HCC) in initially diagnosed HCC patients. METHODS We identified 140 consecutive patients with newly diagnosed HCC (173 HCCs) within the Milan criteria, who underwent liver MRI using gadoxetic acid between 2015 and 2016. One hundred twenty-three consecutive patients without HCC who underwent liver MRI in the same period for HCC surveillance were enrolled for the control group. Two radiologists independently reviewed two MRI sets: a noncontrast set and an abbreviated set. The noncontrast set consists of T2 FSE/ssFSE, T1 in- and out-of-phase image, DWI, and the ADC map. The abbreviated set consists of T2 FSE/ssFSE, hepatobiliary phase image 20 min after gadoxetic acid injection, DWI, and the ADC map. RESULTS In a per-patient analysis, sensitivity of reviewer 1 for noncontrast and abbreviated sets was 85.7 and 90.0%, respectively. The specificity for both noncontrast and abbreviated sets was 92.7%. For reviewer 2, sensitivity of noncontrast and abbreviated sets was 86.4 and 89.3%, respectively. Per-patient specificity of reviewer 2 was 92.7% for both noncontrast and abbreviated sets. The sensitivity and specificity of two image sets were not significantly different for both reviewers. The per-tumor sensitivity of noncontrast and abbreviated sets was 81.5 and 84.4% for reviewer 1, respectively, and 79.8 and 84.4% for reviewer 2, respectively. There was no significant difference. CONCLUSION Noncontrast and abbreviated MRI using gadoxetic acid showed comparable diagnostic performance for detecting patients with HCCs in the early stage. KEY POINTS • Diagnostic performance of noncontrast MRI and abbreviated MRI using gadoxetic acid for detecting HCCs is comparable in patients with HCCs in the early stage. • Noncontrast MRI and abbreviated MRI showed high sensitivity and specificity for detecting HCCs in the early stage. • Outcomes of surveillance for HCC in high-risk patients can be improved by adopting these simplified and focused MRI protocols.

更新日期：2020-03-12

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