Hepatic metastases: Detection with multi-detector row CT, SPIO-enhanced MR imaging, and both techniques combined
Hepatic metastases: Detection with multi-detector row CT, SPIO-enhanced MR imaging, and both techniques combined
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DOI：
10.1148/radiol.2383041825
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发表时间：
2006-04-01
期刊：
影响因子：
19.7
通讯作者：
Nakamura, H
中科院分区：
文献类型：
--
作者：
Onishi, H;Murakami, T;Nakamura, H
目的：回顾性比较对比剂增强多排计算机断层扫描（CT）单独、超顺磁氧化铁（SPIO）增强磁共振（MR）单独、对比剂增强CT和超顺磁氧化铁（SPIO）增强mri联合检测肝转移的准确性。材料和方法：本回顾性研究符合赫尔辛基宣言原则，伦理委员会未要求其批准或知情同意。回顾性分析了38例疑似肝转移患者（22名男性，16名女性，平均年龄64.5岁，范围35-78岁）的资料，这些患者均接受了CT增强和spo增强磁共振成像。38例患者中有21例有61个转移灶。61例转移瘤中有17例经组织学证实；其余44例转移灶通过影像学随访确定。在磁共振成像中，对spio增强的重t1加权图像、T2*加权梯度回波图像和T2加权快速自旋回波图像进行评估。对门静脉期获得的增强多检测器行CT图像进行评估。四名盲法观察者独立审查CT图像，MR图像。采用选择性自由反应受者工作特征（AFROC）方法评估诊断准确性。用Fisher保护最小显著差异检验和广义估计方程分析敏感性和阳性预测值。结果：联合方法的AFROC曲线下平均面积（0.70）明显高于单独spio增强MR成像（0.58）。P < 0.05， Fisher保护最小显著性差异检验)，两者之间无显著性差异（0.66）。对于所有病变，联合成像的平均敏感性（0.59）明显高于单独CT（0.48）或MR成像（0.43）（P < 0.05， Fisher保护最小显著差异检验和广义估计方程）。对于所有病变，MR和CT联合、单独CT和单独MR的平均阳性预测值分别为0.82、0.89和0.81。结论：在对比增强的多排CT基础上增加spio增强MR成像（即spio增强MR图像与对比增强CT图像的联合分析）可以提高肝转移检测的敏感性，尽管在AFROC分析中这种敏感性的提高并不显著。(c) 2006年RSNA。
Purpose: To retrospectively compare the accuracy in detection of hepatic metastases among contrast material-enhanced multi-detector row computed tomography (CT) alone, superparamagnetic iron oxide (SPIO)-enhanced magnetic resonance (MR) imaging alone, and a combination of contrast-enhanced CT and SPIO-enhanced MR imaging.Material and Methods: The ethics committee did not require its approval or informed consent for this retrospective study, which was compliant with Declaration of Helsinki principles. Data in 38 patients (22 men, 16 women; mean age, 64.5 years: range, 35-78 years) suspected of having hepatic metastases who underwent both contrast-enhanced CT and SPIO-enhanced MR imaging were retrospectively analyzed. Twenty-one of the 38 patients had 61 metastases. Seventeen of the 61 metastases were confirmed histologically; the remaining 44 metastases were defined with imaging follow-up. At MR imaging, SPIO-enhanced heavily T1-weighted images, T2*-weighted gradient echo images, and T2-weighted fast spin-echo images were evaluated. Contrast-enhanced multi-detector row CT images obtained in the portal phase were evaluated. Four blinded observers independently reviewed CT images, MR images. Diagnostic accuracy was evaluated by using the alternative free-response receiver operating characteristic (AFROC) method. Sensitivities and positive predictive values were also analyzed with the Fisher protected least significant difference test and generalized estimating equations.Results: The mean area under the AFROC curve for the combined approach (0.70) was significantly higher than that for SPIO-enhanced MR imaging alone (0.58. P < .05, Fisher protected least significant difference test), and there was no significant difference between each of them and that for contrast-enhanced CT alone (0.66). For all lesions, the mean sensitivity of combined imaging (0.59) was significantly higher than that of CT (0.48) or MR imaging (0.43) alone (P < .05, Fisher protected least significant difference test and generalized estimating equations). For all lesions, the mean positive predictive values were 0.82, 0.89, and 0.81, for combined MR and CT, CT alone, and MR alone, respectively.Conclusion: The addition of SPIO-enhanced MR imaging to contrast-enhanced multi-detector row CT (ie, combined analysis of SPIO-enhanced MR images and contrast-enhanced CT images) can improve sensitivity in the detection of hepatic metastases, although this improvement in sensitivity was not significant at AFROC analysis.(c) RSNA 2006.