Hepatocellular carcinoma in patients undergoing living-donor liver transplantation
Hepatocellular carcinoma in patients undergoing living-donor liver transplantation
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DOI：
10.1159/000122597
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发表时间：
2008-01-01
期刊：
影响因子：
4.6
通讯作者：
Kaori, Togashi
中科院分区：
文献类型：
--
作者：
Maetani, Yoji S.;Ueda, Mikiko;Kaori, Togashi
目的：目的比较肝细胞癌（HCC）患者接受活体肝移植（LDLT）后的8排螺旋CT（CT）表现与组织病理学。材料和方法：这项由机构审查委员会批准的前瞻性研究于2003年2月12日至2004年11月12日进行;在78名因HCC接受LDLT的候选者中，48名移植受者符合我们的标准，其中41名患者在MDCT上诊断为HCC病变< 15个;这些患者代表了研究人群。术前CT结果与切除肝脏5 mm矢状切片后的组织病理学结果相关。注射造影剂（2 ml/ kg体重，300 mg l/ml）后，获得三相对比增强图像。使用以下参数进行CT：探测器行配置，8！1 mm，重建间隔1 mm，200 mA s，120 kVp。图像分析由三位腹部放射科医生一致进行，使用1 mm厚的切片，重叠0.5 mm，分页以及多平面重组（MPR; i. e.轴向、冠状和矢状图像）。结果：134例肝细胞癌经病理证实。平均病灶大小为21 mm。所有病灶检测HCC的敏感性、阳性预测值和准确性分别为87、96和84%，> 1 cm病灶分别为99、100和97%，但< 1 cm肿瘤分别为46、76和41%（n = 28）。假阴性12例，假阳性5例.结论：MDCT结合分页法和MPR图像对直径1 ~ 1cm肝癌的检出率高，假阳性率低。版权所有（c）2008 S. Karger AG，巴塞尔。
Objective: To compare 8-detector row helical computed tomography (CT) findings with histopathology in patients with hepatocellular carcinoma (HCC) who had undergone living-donor liver transplantation (LDLT). Materials and Methods: This institutional review board-approved prospective study was performed between February 12, 2003 and November 12, 2004; of the 78 candidates for LDLT due to HCC who underwent preoperative multidetector CT ( MDCT), 48 transplant recipients met our criteria and in 41 of them, HCCs were diagnosed with < 15 lesions on MDCT; these patients represented the study population. Results of preoperative CT were correlated with histopathological results after 5-mm sagittal slicing of the explanted liver. Following the injection of contrast medium ( 2 ml/ kg body weight of 300 mg l/ml), triple-phase contrast-enhanced images were obtained. CT was performed using the following parameters: detector row configuration, 8 ! 1 mm, reconstruction interval, 1 mm, 200 mA s and 120 kVp. Image analysis was performed in consensus by three abdominal radiologists using 1-mm-thick slices with 0.5- mm overlap with paging as well as multiplanar reformatting ( MPR; i. e. axial, coronal and sagittal images). Results: A total of 134 HCCs were identified by pathological examination. The mean lesion size was 21 mm. Sensitivity, positive predictive value and accuracy for HCC detection were 87, 96 and 84% for all lesions, respectively, and 99, 100 and 97% for lesions > 1 cm, respectively, but only 46, 76 and 41% for tumors < 1 cm, respectively ( n = 28). There were 12 false- negative lesions but only 5 false- positive findings. Conclusion: MDCT combined with the paging method and MPR images is very effective in the detection of HCCs 1 1 cm in diameter with a very low false- positive rate. Copyright (c) 2008 S. Karger AG, Basel.