Usefulness of Combination of Imaging Modalities in the Diagnosis of Hepatocellular Carcinoma Using Sonazoid®-Enhanced Ultrasound, Gadolinium Diethylene-Triamine-Pentaacetic Acid-Enhanced Magnetic Resonance Imaging, and Contrast-Enhanced Computed Tomography
Usefulness of Combination of Imaging Modalities in the Diagnosis of Hepatocellular Carcinoma Using Sonazoid®-Enhanced Ultrasound, Gadolinium Diethylene-Triamine-Pentaacetic Acid-Enhanced Magnetic Resonance Imaging, and Contrast-Enhanced Computed Tomography
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DOI：
10.1159/000333264
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发表时间：
2011-01-01
期刊：
影响因子：
3.5
通讯作者：
Kudo, Masatoshi
中科院分区：
文献类型：
--
作者：
Alaboudy, Alshimaa;Inoue, Tatsuo;Kudo, Masatoshi
目的：探讨超声索那唑类(R)增强超声（US）、钆二乙烯-三胺-五乙酸增强（Gd-EOB-DTPA）磁共振成像（MRI）和计算机断层扫描（CECT）结合影像学方法对肝细胞癌（HCC）的诊断能力。方法：对32例行肝细胞癌手术切除的患者进行研究。所有患者均行索那唑类药物增强US、Gd-EOB-DTPA MRI、CECT和术中超声造影检查。在这些患者中，HCC的明确诊断是基于组织病理学的证实。结果：32例患者共获得50例组织学证实的hcc；平均（+/-SD）年龄为68.3岁+/-8.1岁。平均（+/- sd）结节大小为2.6 cm +/- 1.9 cm。20%为高分化HCC， 64%为中分化HCC， 10%为低分化HCC， 4%为HCC合并CCC， 2%为重度坏死HCC。CEUS、CECT和Gd-EOB-DTPA MRI的总体诊断敏感性分别为72%、74%和86%；三种影像学方式对典型HCC的诊断差异无统计学意义（p = 0.092）。综合不同成像方式的诊断能力，sonazod增强US和Gd-EOB-DTPA MRI的诊断敏感性为90%，而sonazod增强US加CECT和CECT加Gd-EOB-DTPA MRI的诊断敏感性分别为82%和88%。三种影像组合间差异无统计学意义（p = 0.970）。结论：索那唑类药物增强US和Gd-EOB-DTPA MRI可用于HCC的日常临床治疗。巴塞尔S. Karger股份有限公司版权所有
Objective: To clarify the diagnostic ability of combining imaging methods to diagnose hepatocellular carcinoma (HCC) using Sonazoid (R)-enhanced ultrasound (US), gadolinium diethylene-triamine-pentaacetic acid-enhanced (Gd-EOB-DTPA) magnetic resonance imaging (MRI), and contrast-enhanced computed tomography (CECT). Methods: A total of 32 patients who underwent surgical resection for HCC were studied. Sonazoid-enhanced US, Gd-EOB-DTPA MRI, CECT, and intraoperative contrast-enhanced ultrasonography were done for all patients. The definitive diagnosis of HCC in those patients was based on histopathological confirmation. Results: A total of 50 histologically proven HCCs were obtained from 32 patients; their mean (+/-SD) age was 68.3 years +/-8.1. The mean (+/-SD) nodule size was 2.6 cm +/- 1.9. Twenty percent were well-differentiated HCC, 64% were moderately differentiated HCC, 10% were poorly differentiated HCC, 4% were combined HCC and CCC, and 2% were HCC with severe necrosis. The overall diagnostic sensitivity of CEUS, CECT, and Gd-EOB-DTPA MRI was 72, 74, and 86%, respectively; however, there was no significant difference between the three imaging modalities in diagnosing typical HCC (p = 0.092). When combining the diagnostic ability of the different imaging modalities, the diagnostic sensitivity of Sonazoid-enhanced US and Gd-EOB-DTPA MRI was 90%, while addition of Sonazoid-enhanced US to CECT and CECT to Gd-EOB-DTPA MRI had a sensitivity of 82 and 88%, respectively. There was no significant difference between the three imaging combinations (p = 0.970). Conclusion: Sonazoid-enhanced US and Gd-EOB-DTPA MRI can be confidently used in daily clinical practice for the management of HCC. Copyright (C) 2011 S. Karger AG, Basel