Liver tumour MRI: what do we need for lesion characterization?
Liver tumour MRI: what do we need for lesion characterization?
复制标题
肝脏肿瘤 MRI：我们需要什么来表征病变？
DOI：
10.1080/00365520310007765
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发表时间：
2004
影响因子：
1.9
通讯作者：
K. Höckerstedt
中科院分区：
文献类型：
--
作者：
K. Numminen;J. Halavaara;P. Tervahartiala;H. Isoniemi;L. Kivisaari;M. Palomäki;K. Höckerstedt
背景资料：肝脏病变构成了临床环境中放射学的日常挑战，非侵入性方法在这些肝脏肿瘤的表征中很有价值。我们进行了研究，通过评价几种非增强MR序列和动态钆（Gd）增强技术来评估MRI的病变表征潜力。研究方法：我们的回顾性研究共纳入116例患者的116个肝脏局灶性病变，其中107个病变可进行组织学验证。9例血管瘤随访2年。使用了1.5T MR系统。T1和T2加权序列和动态Gd增强研究由两名阅片人作为单独序列和共同序列进行评价。病变分为良性或恶性，并提出了具体的诊断。统计分析采用McNemar检验，观察者间变异采用Kappa统计。结果如下：阅片人1和阅片人2分别在83%和89%的病例中评估了良性和恶性肿瘤的病变分类（通过一致评价所有图像）。从单个序列来看，两名阅片师均使用Gd增强T1实现了最佳病变分类。当所有序列与任何单个序列进行比较时，分类差异具有统计学意义（P = 0.02）。 读片者1和2分别在60%和71%的病例中使用所有序列正确确定了特异性诊断。对于单个序列，两名阅片师最常使用Gd增强T1加权序列提出正确诊断（阅片师1和2分别为59%和65%）。结论：使用Gd增强成像的多序列MRI在肝脏病变分类中表现非常好，并且具有确定特定诊断的中等能力。
Background: Hepatic lesions constitute a daily challenge to radiology in clinical settings, and non‐invasive methods are valuable in the characterization of these liver tumours. We undertook our investigation to assess the lesion characterization potential of MRI by evaluating several unenhanced MR sequences and the dynamic gadolinium (Gd)‐enhanced technique. Methods: A total of 116 focal liver lesions in 116 patients were included in our retrospective study, and histological verification was available for 107 lesions. Nine haemangiomas had a follow‐up of 2 years. The 1.5‐T MR system was used. T1‐ and T2‐weighted sequences and dynamic Gd‐enhanced studies were evaluated by two individual readers as separate sequences and also collectively. Lesions were classified into benign or malignant, and a specific diagnosis was proposed. The McNemar test was used in statistical analysis, and interobserver variation was measured using kappa statistics. Results: Lesion classification into benign and malignant tumours (by evaluating all images in concert) was assessed in 83% and 89% of cases by readers 1 and 2, respectively. From single sequences, best lesion classification was achieved with Gd‐enhanced T1 by both readers. The difference in classification was statistically significant when all sequences were evaluated in comparison with any single sequence alone (P = 0.02). Specific diagnosis was correctly determined using all sequences together in 60% and 71% of cases by readers 1 and 2, respectively. For individual sequences, correct diagnosis was most frequently proposed with a Gd‐enhanced T1‐weighted sequence by both readers (59% and 65% for readers 1 and 2, respectively). Conclusion: Multisequential MRI using Gd‐enhanced imaging performs extremely well in liver lesion classification, and with moderate ability to determine a specific diagnosis.