Added value of hepatobiliary phase gadoxetic acid-enhanced MRI for diagnosing hepatocellular carcinoma in high-risk patients

作     者：Sith Phongkitkarun Kuruwin Limsamutpetch Penampai Tannaphai Janjira Jatchavala 

作者机构：Department of Diagnostic and Therapeutic Radiology Faculty of Medicine Ramathibodi Hospital Mahidol University Ratchatewi Bangkok 10400 Thailand 

出 版 物：《World Journal of Gastroenterology》 (世界胃肠病学杂志（英文版）)

年 卷 期：2013年第19卷第45期

页      面：8357-8365页

核心收录：

学科分类：1002[医学-临床医学] 100214[医学-肿瘤学] 10[医学] 

主　　题：Magnetic resonance imaging Liver Gadoxetic acid Hepatobiliary phase Hepatocellular carcinoma 

摘      要：AIM:To determine the added value of hepatobiliary phase(HBP)gadoxetic acid-enhanced magnetic resonance imaging(MRI)in evaluating hepatic nodules in high-risk ***:The institutional review board approved this retrospective study and waived the requirement for informed *** study included 100 patients at high risk for hepatocellular carcinoma(HCC)and 105hepatic nodules that were larger than 1 cm.A blind review of two MR image sets was performed in a random order:set 1,unenhanced(T1-and T2-weighted)and dynamic images;and set 2,unenhanced,dynamic20-min and HBP *** diagnostic accuracy,sensitivity,specificity,positive predictive value(PPV),and negative predictive value(NPV)were compared for the two image *** and multivariate analyses were performed on the MR characteristics utilized to diagnose ***:A total of 105 hepatic nodules were identified in 100 ***-nine nodules were confirmed to be *** diameter of the 59 HCCs ranged from1 to 12 cm(mean:1.9 cm).The remaining 46 nodules were benign(28 were of hepatocyte origin,nine were hepatic cysts,seven were hemangiomas,one was chronic inflammation,and one was focal fat infiltration).The diagnostic accuracy significantly increased with the addition of HBP images,from 88.7%in set 1to 95.5%in set 2(P=0.002).In set 1 vs set 2,the sensitivity and NPV increased from 79.7%to 93.2%and from 78.9%to 91.8%,respectively,whereas the specificity and PPV were not significantly *** hypointensity on the HBP images was the most sensitive(93.2%),and typical arterial enhancement followed by washout was the most specific(97.8%).The multivariate analysis revealed that typical arterial enhancement followed by washout,hyperintensity on T2-weighted images,and hypointensity on HBP images were statistically significant MRI findings that could diagnose HCC(P0.05).CONCLUSION:The addition of HBP gadoxetic acidenhanced MRI statistically improved the diagnostic accuracy in HCCs larger than