Multiparametric gadoxetic acid-enhanced MR versus dual-layer spectral detector CT for differentiating hepatocellular carcinoma from hypervascular pseudolesions.

IF 1.1 4区 医学 Q3 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING
Akahiko Sato, Masahiro Okada, Kenichiro Tago, Yujiro Nakazawa, Mariko Mizuno, Takahiro Miyauchi, Yuko Kobashi
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引用次数: 0

Abstract

BackgroundIt can be difficult to differentiate hypervascular hepatocellular carcinoma (HCC) from hypervascular pseudolesion (HPL) such as arteriovenous shunts.PurposeTo determine retrospectively whether double-layer detector computed tomography (DLCT) can differentiate HCC from HPL compared to gadoxetate-enhanced magnetic resonance imaging (EOB-MRI).Material and MethodsWe retrospectively analyzed 46 patients who underwent EOB-MRI and DLCT for suspected HCCs. Arterial/portal phase and hepatobiliary phase (HBP) on EOB-MRI, T2-weighted (T2W) imaging, diffusion-weighted imaging (DWI), apparent diffusion coefficient (ADC), CT value, iodine-density (ID), atomic-number (Zeff), and electron-density (ED) of the lesion and liver were evaluated. The reduction rates of ID (R-ID) between each phase of the arterial/portal phase on EOB-MRI were calculated. ROC analysis was performed to determine the accuracy for differentiating HCC from HPL.ResultsThere were 55 HCCs and 14 HPLs. On DWI, 42, 11, and two HCCs showed high, slightly high, and iso intensity, respectively. However, all 14 HPLs showed iso intensity on DWI. Area under ROC curve (AUC) of DWI (0.982, 95% confidence interval [CI]=0.957-1) was significantly higher than that of HBP (AUC=0.714; 95% CI=0.580-0.849; P < 0.001), R-ID (AUC=0.742, 95% CI=0.580-0.903; P = 0.004), and ED of portal phase (AUC=0.786, 95% CI=0.640-0.891; P = 0.001) in differentiating HCC and HPL. ADC (<0.001), T2W imaging (<0.001), HBP (<0.001), ED-arterial-phase (<0.001), ED-portal-phase (=0.003), ED-equilibrium-phase (=0.001), R-ID-between-arterial/equilibrium-phase (=0.032), and R-ID-between-portal/equilibrium-phase (=0.042) showed significant differences between HPL and HCC.ConclusionDWI is most useful for differentiating HCC from HPL, although ADC, T2W, HBP, R-ID, and ED may also be relatively useful to differentiate between HPLs and HCCs.

背景很难将高血管性肝细胞癌(HCC)与高血管性假肿物(HPL)(如动静脉分流)区分开来。目的回顾性研究双层探测器计算机断层扫描(DLCT)与钆塞酸盐增强磁共振成像(EOB-MRI)相比能否区分HCC和HPL。我们评估了 EOB-MRI 的动脉期/门脉期和肝胆期 (HBP)、T2-加权成像 (T2W)、弥散加权成像 (DWI)、表观弥散系数 (ADC)、CT 值、病灶和肝脏的碘密度 (ID)、原子序数 (Zeff) 和电子密度 (ED)。计算了 EOB-MRI 上动脉/门脉期各阶段之间的 ID 降低率(R-ID)。结果共有 55 例 HCC 和 14 例 HPL。在 DWI 上,分别有 42 个、11 个和 2 个 HCC 表现为高强度、稍高强度和等强度。然而,所有 14 个 HPL 在 DWI 上均显示等强度。在区分 HCC 和 HPL 方面,DWI 的 ROC 曲线下面积(AUC)(0.982,95% 置信区间 [CI]=0.957-1)明显高于 HBP(AUC=0.714;95% CI=0.580-0.849;P P = 0.004)和门脉期 ED(AUC=0.786,95% CI=0.640-0.891;P = 0.001)。ADC (
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来源期刊
Acta radiologica
Acta radiologica 医学-核医学
CiteScore
2.70
自引率
0.00%
发文量
170
审稿时长
3-8 weeks
期刊介绍: Acta Radiologica publishes articles on all aspects of radiology, from clinical radiology to experimental work. It is known for articles based on experimental work and contrast media research, giving priority to scientific original papers. The distinguished international editorial board also invite review articles, short communications and technical and instrumental notes.
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