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MRI versus 64-row MDCT for diagnosis of hepatocellular carcinoma

World Journal of Gastroenterology 2009年第48期15卷 6044-6051页

作者： Michael Bernhard Pitton roman kloeckner Sascha Herber Gerd Otto Karl Friedrich Kreitner Christoph Dueber Department of Diagnostic and Interventional Radiology Johannes Gutenberg-University Department of Transplantation and Hepatobili-opancreatic Surgery University of Mainz

AIM:To compare the diagnostic capability of multidetector computed tomography(MDCT) and magnetic resonance imaging(MRI) for the detection of hepatocellular carcinoma(HCC) tumour nodules and their effect on patient ***:A total of 28 patients(25 male,3 female,mean age 67±10.8 years) with biopsy-proven HCC were investigated with 64-row MDCT(slice 3 mm native,arterial and portal-venous phase,120 mL Iomeprol,4 mL/s,delay by bolus trigger) and MRI(T1fs fl2d TE/ TR 2.72/129 ms,T2tse TE/TR 102/4000 ms,5-phase dynamic contrast-enhanced T1fs fl3d TE/TR 1.56/4.6,Gadolinium-DTPA,slice 4 mm).Consensus reading of both modalities was used as *** nodules were analyzed with respect to number,size,and ***:In total,162 tumour nodules were detected by consensus *** detected signifi cantly more tumour nodules(159 vs 123,P20 *** missed 2 nodules ≤10 mm and 1 nodule ≤15 *** MRI,nodule diameters were greater than on CT(29.2±25.1 mm,range 5-140 mm vs 24.1±22.7 mm,range 4-129 mm,P<0.005).In 2 patients,MDCT showed only unilobar tumour spread,whereas MRI revealed additional nodules in the contralateral *** of these nodules could have changed the therapeutic ***:Contrast-enhanced MRI is superior to 64-row MDCT for the detection of HCC *** should be allocated to interventional or operative treatment according to a dedicated MRI-protocol.

关键词：磁共振成像螺旋CT 肝癌诊断

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Intrahepatic cholangiocarcinoma: Introducing the preoperative prediction score based on preoperative imaging

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Hepatobiliary & Pancreatic Diseases International 2021年第3期20卷 262-270页

作者： Fabian Bartsch Felix Hahn Lukas Müller Janine Baumgart Maria Hoppe-Lotichius roman kloeckner Hauke Lang Department of General Visceral and Transplant SurgeryUniversity Medical Center of the Johannes Gutenberg-University MainzLangenbeckst155131 MainzGermany Department of Diagnostic and Interventional Radiology University Medical Center of the Johannes Gutenberg-University MainzLangenbeckst155131 MainzGermany

Background: Intrahepatic cholangiocarcinoma(ICC) still has a poor long-term outcome, even after complete resection. We investigated different parameters gathered in preoperative imaging and analyzed their influence on resectability, recurrence, and survival. Methods: All patients who underwent exploration due to ICC between January 2008 and June 2018 were analyzed retrospectively. Kaplan-Meier model, log-rank test and Cox regression were used. Results: Out of 184 patients, 135(73.4%) underwent curative intended resection. Median overall survival(OS) was 22.2 months with a consecutive 1-, 3-and 5-year OS of 73%, 29%, and 17%. Median recurrencefree survival(RFS) was 9.3 months with a consecutive 1-, 3-and 5-year RFS of 36%, 15%, and 11%. Site of tumor, parenchymal localization, tumor configuration/dissemination, and estimated tumor volume had significant influence on resectability. Univariate analyses showed that site of tumor, tumor configuration/dissemination, number of nodules, and estimated tumor volume had predictive values for OS and RFS. Together with tumor size the preoperative prediction(POP) score was created showing significance for OS and RFS(all P<0.001). In multivariate analysis, POP score(HR=1.779;95% CI: 1.26 8-2.4 95;P=0.001), T stage(HR=1.255;95% CI: 1.040-1.514;P=0.018) and N stage(HR=1.334;95% CI: 1.081-1.645;P=0.007) were the independent predictors for OS. For RFS, POP score(HR=1.733;95% CI: 1.30 0-2.311;P<0.0 01) and M stage(HR=3.036;95% CI: 1.376-6.697;P=0.006) were the independent predictors. Conclusions: The POP score showed to have a highly significant influence on OS and RFS. The score is easy to assess through preoperative imaging. For patients in the high risk group at least staging laparoscopy or preoperative chemotherapy should be evaluated, because they showed equal outcome compared to the irresectable group.

关键词： Intrahepatic cholangiocarcinoma Cholangiocarcinoma Liver surgery Preoperative imaging Survival

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