非对比MRI与加多西酸增强简化方案在检测结直肠肝转移中的比较评价。

IF 4.1 2区医学 Q1 RADIOLOGY, NUCLEAR MEDICINE & MEDICAL IMAGING

Insights into Imaging Pub Date : 2025-01-02 DOI:10.1186/s13244-024-01886-3

Haoran Dai, Cheng Yan, Xi Jia, Yuyao Xiao, Xinyue Liang, Chun Yang, Kai Liu, Mengsu Zeng

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引用次数: 0

摘要

目的：本研究比较非造影剂缩短MRI与加多西酸增强缩短MRI对结直肠癌肝转移（CRLM）的诊断效果，重点关注病变特征和监测。方法：94例患者，其中病理证实的CRLM患者55例，共422个病变（转移287例，良性135例）。两位独立的读者评估了每位患者的三种MRI方案：方案1包括非对比序列（t2加权涡轮自旋回波，t1加权Dixon，弥散加权成像（DWI）和ADC制图）。方案2包括加多乙酸增强肝胆期显像、T2 TSE、DWI和ADC图。方案3采用标准的加多西酸增强MRI序列，包括对比前t1加权成像、t1加权Dixon序列、对比后t1加权成像（包括动脉、门静脉、过渡期和肝胆期）以及附加的t2加权和DWI序列。诊断以5分制评分(良性= 1；恶性= 5)，评分≥3分提示CRLM。ROC曲线分析诊断准确性，比较不同方案的曲线下面积（AUC）值。结果：方案1（0.899-0.909）、方案2（0.906-0.931）与方案3（0.935-0.939）的auc无显著差异（p = 0.091-0.195）。对于≤10 mm的病变，方案1的疗效略低于方案3 (p = 0.002-0.032)，而方案2的疗效相当（p = 0.096-0.179）。当使用≥4的阈值来定义CRLM时，这些发现成立。结论：非增强缩短MRI方案与加多西酸增强方案鉴别CRLM同样有效。提出的Ab-MRI方法可能是CRLM监测的可行替代方法。关键相关性声明：在识别结直肠癌肝转移（CRLM）方面，非增强的简化MRI （Ab-MRI）方案与加多etic酸增强方案同样有效。提出的Ab-MRI方法可能是CRLM监测的可行替代方法。重点：提出了两种简化的大肠癌肝转移（CRLM）监测方案。非强化方案效果相当，成本效益更高。非增强协议可能是CRLM监测的可行替代方案。

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Comparative evaluation of non-contrast MRI versus gadoxetic acid-enhanced abbreviated protocols in detecting colorectal liver metastases.

Purpose: This study compares the diagnostic efficacy of non-contrast abbreviated MRI protocols with Gadoxetic acid-enhanced abbreviated MRI for detecting colorectal liver metastasis (CRLM), focusing on lesion characterization and surveillance.

Methods: Ninety-four patients, including 55 with pathologically verified CRLM, were enrolled, totaling 422 lesions (287 metastatic, 135 benign). Two independent readers assessed three MRI protocols per patient: Protocol 1 included non-contrast sequences (T2-weighted turbo spin-echo, T1-weighted Dixon, diffusion-weighted imaging (DWI), and ADC mapping). Protocol 2 included gadoxetic acid enhancement with hepatobiliary phase imaging, T2 TSE, DWI, and ADC maps. Protocol 3 utilized the standard Gadoxetic Acid-enhanced MRI sequence, which included pre-contrast T1-weighted imaging, T1-weighted Dixon sequences, post-contrast T1-weighted imaging (including arterial, portal venous, transitional and hepatobiliary phases), and additional T2-weighted and DWI sequences. Diagnoses were scored on a 5-point scale (benign = 1; malignant = 5), with scores ≥ 3 indicating CRLM. ROC curves analyzed diagnostic accuracy, comparing area under the curve (AUC) values across protocols.

Results: No significant difference in AUCs was observed between Protocol 1 (0.899-0.909) and Protocol 2 (0.906-0.931) versus Protocol 3 (0.935-0.939) (p = 0.091-0.195). For lesions ≤ 10 mm, Protocol 1 was slightly inferior to Protocol 3 (p = 0.002-0.032), while Protocol 2 remained comparably effective (p = 0.096-0.179). These findings held when using a threshold of ≥ 4 to define CRLM.

Conclusion: The non-enhanced abbreviated MRI protocol is as effective as the gadoxetic acid-enhanced protocol in identifying CRLM. The proposed Ab-MRI approach may be a viable alternative for CRLM surveillance.

Critical relevance statement: The non-enhanced abbreviated MRI (Ab-MRI) protocol is as effective as the gadoxetic acid-enhanced protocol in identifying colorectal liver metastasis (CRLM). The proposed Ab-MRI approach may be a viable alternative for CRLM surveillance.

Key points: Two abbreviated protocols are proposed for colorectal liver metastasis (CRLM) surveillance. The non-enhanced protocol showed equivalent efficacy and was more cost-effective. The non-enhanced protocol may be a viable alternative for CRLM surveillance.

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来源期刊

Insights into Imaging Medicine-Radiology, Nuclear Medicine and Imaging

CiteScore

7.30

自引率

4.30%

发文量

182

审稿时长

13 weeks

期刊介绍： Insights into Imaging (I³) is a peer-reviewed open access journal published under the brand SpringerOpen. All content published in the journal is freely available online to anyone, anywhere! I³ continuously updates scientific knowledge and progress in best-practice standards in radiology through the publication of original articles and state-of-the-art reviews and opinions, along with recommendations and statements from the leading radiological societies in Europe. Founded by the European Society of Radiology (ESR), I³ creates a platform for educational material, guidelines and recommendations, and a forum for topics of controversy. A balanced combination of review articles, original papers, short communications from European radiological congresses and information on society matters makes I³ an indispensable source for current information in this field. I³ is owned by the ESR, however authors retain copyright to their article according to the Creative Commons Attribution License (see Copyright and License Agreement). All articles can be read, redistributed and reused for free, as long as the author of the original work is cited properly. The open access fees (article-processing charges) for this journal are kindly sponsored by ESR for all Members. The journal went open access in 2012, which means that all articles published since then are freely available online.