Gadoxetate-enhanced Abbreviated MRI for Hepatocellular Carcinoma Surveillance: Preliminary Experience
Gadoxetate-enhanced Abbreviated MRI for Hepatocellular Carcinoma Surveillance: Preliminary Experience
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DOI：
10.1148/rycan.2019190010
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发表时间：
2019-11-01
期刊：
影响因子：
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通讯作者：
Sirlin, Claude B.
中科院分区：
文献类型：
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作者：
Brunsing, Ryan L.;Chen, Dennis H.;Sirlin, Claude B.
目的：描述钆塞酸二钠增强简化MRI用于肝硬化或慢性B型肝炎病毒（cHBV）患者肝细胞癌（HCC）筛查和监测的单中心初步经验。材料和方法：这是一项回顾性研究，研究对象为至少接受过一种钆塞酸盐治疗的18岁及以上肝硬化或cHBV患者，从2014年到2016年，增强的简化MRI检查用于HCC监测。检查由六位腹部放射科医生之一进行前瞻性解释，以进行临床护理。从电子病历中提取临床、影像学和其他数据。在所有患者中评估诊断充分性。诊断准确性进行了评估，在亚组的患者谁可以被归类为有肝细胞癌或没有肝细胞癌的基础上的复合参考standard.Results：在这项研究中，330例患者（93%肝硬化; 45%的妇女;平均年龄，59岁）进行钆塞酸盐增强缩写MRI。在330例患者中，311例（94.2%）基线钆塞酸盐增强简化MRI检查诊断充分。在330例患者中的141例（43%）中，91.4%（129/141）可被归类为未患有HCC，8.6%（12/141）可被归类为患有HCC。基线钆塞酸盐增强简化MRI检测HCC的敏感性为0.92（95%置信区间[CI]：0.62，1.00），特异性为0.91（95% CI：0.84，0.95）。在330例接受基线钆塞酸盐增强简化MRI的患者中，187例（57%）失访。结论：钆塞酸盐增强简化MRI在临床上是可行的，具有较高的诊断充分率，并且根据我们的初步经验，准确地描述了肝癌高危患者。需要制定加强后续遵守的战略。（C）RSNA，2019
Purpose: To describe a single-center preliminary experience with gadoxetate disodium-enhanced abbreviated MRI for hepatocellular carcinoma (HCC) screening and surveillance in patients with cirrhosis or chronic hepatitis B virus (cHBV).Materials and Methods: This was a retrospective study of consecutive patients aged 18 years and older with cirrhosis or cHBV who underwent at least one gadoxetate-enhanced abbreviated MRI examination for HCC surveillance from 2014 through 2016. Examinations were interpreted prospectively by one of six abdominal radiologists for clinical care. Clinical, imaging, and other data were extracted from electronic medical records. Diagnostic adequacy was assessed in all patients. Diagnostic accuracy was assessed in the subset of patients who could be classified as having HCC or not having HCC on the basis of a composite reference standard.Results: In this study, 330 patients (93% with cirrhosis; 45% women; mean age, 59 years) underwent gadoxetate-enhanced abbreviated MRI. In the 330 patients, 311 (94.2%) baseline gadoxetate-enhanced abbreviated MRI examinations were diagnostically adequate. Of 141 (43%) of the 330 patients, 91.4% (129 of 141) could be classified as not having HCC and 8.6% (12 of 141) could be classified as having HCC. Baseline gadoxetate-enhanced abbreviated MRI had 0.92 sensitivity (95% confidence interval [CI]: 0.62, 1.00) and 0.91 specificity (95% CI: 0.84, 0.95) for detection of HCC. Of the 330 patients who underwent baseline gadoxetate-enhanced abbreviated MRI, 187 (57%) were lost to follow-up.Conclusion: Gadoxetate-enhanced abbreviated MRI is feasible clinically, has a high diagnostic adequacy rate, and, on the basis of our preliminary experience, accurately depicts HCC in high-risk patients. Strategies to enhance follow-up compliance are needed. (C)RSNA, 2019