The role of diffusion-weighted imaging in the detection of hepatic metastases from colorectal cancer: A comparison with unenhanced and Gd-EOB-DTPA enhanced MRI
The role of diffusion-weighted imaging in the detection of hepatic metastases from colorectal cancer: A comparison with unenhanced and Gd-EOB-DTPA enhanced MRI
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DOI：
10.1016/j.ejrad.2016.02.011
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发表时间：
2016-05-01
影响因子：
3.3
通讯作者：
Filippone, Antonella
中科院分区：
文献类型：
--
作者：
Colagrande, Stefano;Castellani, Alessandro;Filippone, Antonella
目的：比较DWI与钆塞酸二钠增强MRI在结直肠癌肝转移灶检测中的作用。方法：本回顾性研究包括54例患者，115例肝转移灶，经伦理委员会批准。所有患者在MRI后两周内接受术中超声和手术切除。将图像分为4组，由两名放射科医生在不同的时间段进行分析：平扫T1-T2 w（A组），A + DWI（B组），A+钆酸二钠（C组），A + DWI+钆酸二钠（D组）。对于每组，报告了转移瘤的存在/大小/部位。观察者间一致性和统计学显著性分别采用Cohen 'skappa和Mc-Nemar's检验。A/B/C/D组的平均灵敏度值分别为84.3/92.1/95.6/97.3%。平均特异性、阳性预测值、阴性预测值和准确度值在各组中也显著且逐渐增加：特异性从62.5%（A组）增加至85.0%，阳性预测值从92.8%增加至97.3%，阴性预测值从41.0%增加至85.1%，准确度从81.1%增加至95.5%。对于每个读者从A到D，假阴性的数量逐渐decreasing.Conclusions：对于两个读者，DWI改善了所有的统计参数在未增强的检查，为结节无论是小于或大于1厘米，而在EOB增强检查DWI precedented增加特异性/阴性预测值。(C)2016爱思唯尔爱尔兰有限公司版权所有。
Objectives: To compare the role of DWI vs. gadoxetic-acid-disodium enhanced MRI in the detection of colorectal hepatic metastases.Methods: Fifty-four patients with 115 hepatic metastases were included in this retrospective study, approved by the Ethical Board. All patients underwent intraoperative-ultrasound and surgical resection within two weeks after MRI. Images were grouped in 4 sets, which were analyzed by two radiologists in different sessions: unenhanced T1-T2w (set A), set A plus DWI (set B), set A plus gadoxetic-acid-disodium (set C), set A plus DWI plus gadoxetic-acid-disodium (set D). For each set, metastases presence/size/site was reported. Interobserver agreement and statistical significance were assessed by Cohen's kappa and Mc-Nemar's test, respectively.Results: Readers' agreement was always very good (k > 0.80). Mean sensitivity values were 84.3/92.1/95.6/97.3% for set A/B/C/D, respectively. Mean specificity, positive predicted, negative predicted, and accuracy values strongly and progressively increased in the various set too: from 62.5% (set A) to 85.0% as for specificity, from 92.8% to 97.3% as for positive predicted value, from 41.0% to 85.1% as for negative predicted value, and from 81.1% to 95.5% as for accuracy. For each reader from set A to D, the number of false negatives progressively decreases.Conclusions: For both readers, DWI improved all statistical parameters in the unenhanced examinations, as for nodules either smaller or greater than 1 cm, while in the EOB-enhanced examinations DWI prevalently increased specificity/negative predictive value. (C) 2016 Elsevier Ireland Ltd. All rights reserved.