Does Gadoxetic acid-enhanced 3.0T MRI in addition to 64-detector-row contrast-enhanced CT provide better diagnostic performance and change the therapeutic strategy for the preoperative evaluation of colorectal liver metastases?
Does Gadoxetic acid-enhanced 3.0T MRI in addition to 64-detector-row contrast-enhanced CT provide better diagnostic performance and change the therapeutic strategy for the preoperative evaluation of colorectal liver metastases?
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DOI：
10.1007/s00330-014-3233-7
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发表时间：
2014-10-01
影响因子：
5.9
通讯作者：
Sugimura, Kazuro
中科院分区：
文献类型：
--
作者：
Sofue, Keitaro;Tsurusaki, Masakatsu;Sugimura, Kazuro
比较单独 64 排造影增强 CT (CE-CT) 与 3.0T 下 CE-CT 与钆塞酸增强 MRI (EOB-MRI) 组合在结直肠肝转移检测中的诊断性能，并评估 EOB-MRI 除 CE-CT 之外是否会导致最初计划手术策略的改变。 共有 39 名患者（27 名男性，平均年龄 65 岁），85 名患者包括经组织病理学证实的肝转移。在 EOB-MRI 中，获得了未增强（T1 和 T2 加权）、动态和肝细胞期图像。在CE-CT上，获得了四相动态对比增强图像。一名现场审稿人和三名场外审稿人独立审查了单独的CE-CT以及CE-CT和EOB-MRI的组合。计算灵敏度、阳性预测值和替代自由反应受试者工作特征（AFROC）方法。还评估了EOB-MRI检查前后治疗策略的差异。CE-CT和EOB-MRI联合检查的敏感性和AFROC曲线下面积明显优于单独使用CE-CT。 39 例患者中有 13 例记录了手术治疗的变化。CE-CT 和 EOB-MRI 的组合在检测结直肠肝转移方面可能比单独使用 CE-CT 提供更好的诊断性能，并且除了 CE-CT 之外的 EOB-MRI 导致三分之一患者改变了计划的手术策略。a 欧元 准确的术前成像对于手术计划和成功的肝切除至关重要。a 欧元 CE-CT 和 EOB-MRI 的组合可用于检测结直肠肝转移。欧洲 EOB-MRI 与 CE-CT 相结合有助于确定正确的治疗策略。
To compare diagnostic performance in the detection of colorectal liver metastases between 64-detector-row contrast-enhanced CT (CE-CT) alone and the combination of CE-CT and gadoxetic acid-enhanced MRI (EOB-MRI) at 3.0T, and to assess whether EOB-MRI in addition to CE-CT results in a change to initially planned operative strategy.A total of 39 patients (27 men, mean age 65 years) with 85 histopathologically confirmed liver metastases were included. At EOB-MRI, unenhanced (T1- and T2-weighted), dynamic, and hepatocyte-phase images were obtained. At CE-CT, four-phase dynamic contrast-enhanced images were obtained. One on-site reader and three off-site readers independently reviewed both CE-CT alone and the combination of CE-CT and EOB-MRI. Sensitivity, positive predictive value, and alternative free-response receiver operating characteristic (AFROC) method were calculated. Differences in therapeutic strategy before and after the EOB-MRI examination were also evaluated.Sensitivity and area under the AFROC curve with the combination of CE-CT and EOB-MRI were significantly superior to those with CE-CT alone. Changes in surgical therapy were documented in 13 of 39 patients.The combination of CE-CT and EOB-MRI may provide better diagnostic performance than CE-CT alone for the detection of colorectal liver metastases, and EOB-MRI in addition to CE-CT resulted in changes to the planned operative strategy in one-third of the patients.aEuro cent Accurate preoperative imaging is essential for surgical planning and successful hepatic resection.aEuro cent Combination of CE-CT and EOB-MRI is useful to detect colorectal liver metastases.aEuro cent EOB-MRI combined with CE-CT contributes to determine the correct therapeutic strategy.