MRI angiography is superior to helical CT for detection of HCC prior to liver transplantation:: An explant correlation
MRI angiography is superior to helical CT for detection of HCC prior to liver transplantation:: An explant correlation
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DOI：
10.1053/jhep.2003.50409
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发表时间：
2003-10-01
期刊：
影响因子：
13.5
通讯作者：
Bruix, J
中科院分区：
文献类型：
--
作者：
Burrel, M;Llovet, JM;Bruix, J
螺旋计算机断层扫描（CT）和磁共振成像（MRI）用于肝细胞癌（HCC）的分期之前，根治性治疗，但低估了30%至50%的情况下，与病理取出肿瘤的扩展。本研究比较了一种新的技术，磁共振血管造影（MRA），与三期螺旋CT检测肝癌。分析了50例接受肝移植的患者，其中29例为HCC。MRA采用屏气快速扰相梯度回波序列，有效层厚2 ~ 2.5mm，以病理检查（肝脏切片为5 mm）为金标准。在取出时确定了127个病变：76个HCC，13个高度发育不良结节，31个宏观再生结节，7个血管瘤。主要HCC结节的直径为29 +/- 14 mm，47个额外结节的直径为11 +/- 7 mm。就每个结节而言，MRA的灵敏度优于CT（分别为58/76 [76%]与43/70 [61%]，P = 0.001）。上级。MRA检测额外结节的灵敏度随大小而降低（>20 mm：6/6 [100%]; 10-20 mm：16/19 [84%]; < 10 mm：7/22。[32对于10 ~ 20 mm的结节，其诊断率上级优于CT（84% vs. 47%，P = 0.016）。MRA上>5 mm的非特异性多血管结节在三分之二的病例中为HCC。总之，MRA对直径大于或等于10 mm的HCC有很高的诊断准确性，并且在直径为10 - 20 mm的结节中比三期螺旋CT更敏感。MRA是HCC治疗前分期的最佳技术。
Helical computerized tomography (CT) and magnetic resonance imaging (MRI) are used for staging of hepatocellular carcinoma (HCC) prior to curative treatments but underestimate tumor extension in 30% to 50% of cases when compared with pathologic explants. This study compares a new technology, MRI angiography (MRA), with triphasic helical CT in detection of HCC. Fifty cirrhotic patients, 29 with HCC, undergoing liver transplantation were analyzed. MRA was performed with a 3-D breath-hold fast spoiled gradient-echo sequence by using an effective section thickness of 2 to 2.5 mm. The gold standard was the pathologic examination (liver cut into 5-mm slices). One hundred twenty-seven lesions were identified at the explant: 76 HCC, 13 high-grade dysplastic nodules, 31 macroregenerative nodules, 7 hemangiomas. Diameter of the main HCC nodules was 29 +/- 14 mm and 11 +/- 7 mm for the 47 additional nodules. On a per nodule basis, sensitivity of MRA was superior to CT (58/76 [76%] vs. 43/70 [61%], respectively, P =.001). Sensitivity of MRA for detection of additional nodules decreased with size (>20 mm: 6/6 [100%]; 10-20 mm: 16/19 [84%]; < 10 mm: 7/22.[32%]) and was superior to CT for nodules 10 to 20 mm (84% vs. 47%, P =.016). Nonspecific hypervascular nodules >5 mm at MRA were HCC in two thirds of the cases. In conclusion, MRA has a high diagnostic accuracy for HCC greater than or equal to10 mm and is more sensitive than triphasic helical CT in nodules sized 10 to 20 mm. MRA is the optimal technique for HCC staging prior to curative therapies.