Feasibility of Routine Application of Gadoxetic Acid-Enhanced MRI in Combination with Diffusion-Weighted MRI for the Preoperative Evaluation of Colorectal Liver Metastases
Feasibility of Routine Application of Gadoxetic Acid-Enhanced MRI in Combination with Diffusion-Weighted MRI for the Preoperative Evaluation of Colorectal Liver Metastases
复制标题
常规应用钆塞酸增强MRI联合弥散加权MRI对结直肠肝转移瘤术前评估的可行性
DOI：
--
复制
发表时间：
2016
影响因子：
3.7
通讯作者：
K. Shimada
中科院分区：
文献类型：
--
作者：
Masahiro Tanaka;Y. Kishi;M. Esaki;S. Nara;M. Miyake;N. Hiraoka;M. Nagino;K. Shimada
背景钆塞酸增强磁共振成像 (MRI) 与弥散加权 MRI (Gd-EOB-MRI/DWI) 相结合已成为评估结直肠肝转移 (CRLM) 的常用方法。本回顾性观察性研究旨在确定所有CRLM患者在肝切除术前是否应进行该手术。方法对2008年至2014年因CRLM接受肝切除术的患者的相关数据进行回顾性调查。评估了对比增强计算机断层扫描 (CE-CT) 和 Gd-EOB-MRI/DWI 的检出率。此外，还比较了仅接受 CE-CT 的患者与同时接受 CE-CT 和 Gd-EOB-MRI/DWI 的患者初次肝切除术后的无复发生存率和总生存率。结果总共有 177 名患者的 202 例肝切除术中切除了 419 例经病理证实的 CRLM。 CE-CT 的 CRLM 检测灵敏度为 77%，Gd-EOB-MRI/DWI 的 CRLM 检测灵敏度为 93%（P < 0.01）。 CE-CT 检测 1-5、6-10 和 11-15 mm CRLM 的灵敏度分别为 9.6%（5/52）、47%（26/55）和 76%（57/75），而 Gd-EOB-MRI/DWI 检测灵敏度分别为 54%（28/52）、91%（50/55）和分别为 99% (74/75)；这些差异非常显着（所有三组的 P < 0.01）。术前仅通过 CE-CT 评估的 37 名患者与同时通过 CE-CT 和 Gd-EOB-MRI/DWI 评估的 168 名患者之间，无复发 (P = 0.99) 和总生存 (P = 0.79) 没有显着差异。 结论 Gd-EOB-MRI/DWI 检测小 CRLM (≤15 mm) 的灵敏度比 CE-CT 更高。然而，就生存获益而言，Gd-EOB-MRI/DWI 是否应成为术前评估的常规组成部分仍不清楚。
BackgroundGadoxetic acid-enhanced magnetic resonance imaging (MRI) in combination with diffusion-weighted MRI (Gd-EOB-MRI/DWI) has become popular for evaluating colorectal liver metastases (CRLM). This retrospective observational study aimed to determine whether this procedure should be indicated prior to hepatectomy in all patients with CRLM.MethodsA retrospective survey of relevant data of patients who had undergone hepatectomy for CRLM from 2008 to 2014 was performed. The rates of detection by contrast-enhanced computed tomography (CE-CT) and Gd-EOB-MRI/DWI were evaluated. In addition, relapse-free and overall survivals after primary hepatectomy were compared between patients who had undergone only CE-CT versus those who had undergone both CE-CT and Gd-EOB-MRI/DWI.ResultsIn all, 419 pathologically confirmed CRLM were resected in 202 hepatectomies in 177 patients. The sensitivity of detection of CRLM was 77 % for CE-CT and 93 % for Gd-EOB-MRI/DWI (P < 0.01). The sensitivity of detection of 1–5, 6–10, and 11–15 mm CRLM by CE-CT was 9.6 % (5/52), 47 % (26/55), and 76 % (57/75), respectively, whereas that by Gd-EOB-MRI/DWI was 54 % (28/52), 91 % (50/55), and 99 % (74/75), respectively; these differences are significant (P < 0.01 for all three groups). Relapse-free (P = 0.99) and overall survival (P = 0.79) did not differ significantly between 37 patients evaluated preoperatively by only CE-CT and 168 patients evaluated by both CE-CT and Gd-EOB-MRI/DWI.ConclusionGd-EOB-MRI/DWI detects small CRLM (≤15 mm) with higher sensitivity than CE-CT. However, whether Gd-EOB-MRI/DWI should be a routine component of preoperative evaluation remains unclear in terms of survival benefit.
门脉相增强螺旋 CT 用于检测恶性肝肿瘤：基于与术中和病理结果比较的敏感性。
DOI：
10.2214/ajr.166.1.8571914
发表时间：
1996
期刊：
AJR. American journal of roentgenology
影响因子：
--
作者：
Kuszyk,BS;Bluemke,DA;Urban,BA;Choti,MA;Hruban,RH;Sitzmann,JV;Fishman,EK
通讯作者：
Fishman,EK
影响因子：
51.1
作者：
Nordlinger, Bernard;Sorbye, Halfdan;Gruenberger, Thomas
通讯作者：
Gruenberger, Thomas