• Clinical Article •
Clinical value of Gd-EOB-DTPA-enhanced MRI for diagnosis of focal hepatic lesions
DOI:10.12015/issn.1674-8034.2018.02.005.
| [Abstract] Objective: To evaluate the application value of Gd-EOB-DTPA-enhanced MRI for diagnosing focal hepatic lesions.Materials and Methods: The Gd-EOB-DTPA- enhanced MRI and clinical datas of 34 cases of focal hepatic leisons were enrolled in this study. The pathological results were 20 cases of hepatocellular carcinoma (HCC), 4 cases of intrahepatic cholangiocarcinoma (ICC), 2 cases of combined hepatocellular carcinoma and cholangiocarcinoma (cHCC-CC), 7 cases of focal nodular hyperplasia (FNH) and 1 case of hepatic angiomyolipoma (HAML). Two radiologists separately analyzed MRI datas in blind way and made pathological diagnosis. Based on postoperative pathological results, diagnosis veracity and consistency of two radiologists were compared.Results: In dynamic contrast phase of Gd-EOB-DTPA enhanced MRI: 5 cases of HCC turned out to be atypical, including 3 cases of mild-enhanced HCC in arterial phase and 2 cases of HCC without obvious washout in transition phase. 1 case of FNH showed a little lower signal intensity than liver parenchyma in transition phase. 2 cases of cHCC-CC both had irregularly dynamic enhancement feature and possessed obvious feeding artery. In hepatobiliary phase: 1 case of HCC showed high signal intensity while the rest HCC were obviously low signal intensity. 4 cases of ICC performed low singal intensity within cloud mild-high signal intensity. 2 cases of cHCC-CC both were low signal intensity within lower signal intensity in the centre. 1 case of FNH featured slightly-low signal intensity within target high signal intensity. The diagnostic accuracy of two radiologists were 94.12% (32/34) and 97.06% (33/34) and the difference had no statistical significance (χ2=0.349, P>0.05). Furthermore, the diagnosis consistency between radiologists was good (kappa=0.945, P<0.05).Conclusions: Gd-EOB-DTPA enhanced MRI may improve the diagnosis veracity of focal hepatic lesion and it has important clinical value. |
| [Keywords] Gd-EOB-DTPA；Focal hepatic lesion；Hepatobiliary phase；Magnetic resonance imaging |
BAI Xiu-yan Department of Radiology, General Hospital of Liaoyang Petrochemical, Liaoyang 111000, China; Department of Radiology, General Hospital of Shenyang Military Command, Shenyang 110000, China
SUN Yu Department of Radiology, General Hospital of Shenyang Military Command, Shenyang 110000, China
HOU Jie Department of Radiology, General Hospital of Shenyang Military Command, Shenyang 110000, China
ZHANG Nan Department of Radiology, General Hospital of Shenyang Military Command, Shenyang 110000, China
MA Xiang-hong Department of Radiology, General Hospital of Shenyang Military Command, Shenyang 110000, China
WANG Wei Department of Radiology, General Hospital of Shenyang Military Command, Shenyang 110000, China
YANG Ben-qiang* Department of Radiology, General Hospital of Shenyang Military Command, Shenyang 110000, China
*Correspondence to: Yang BQ, E-mail: bqyang888@sina.com
Conflicts of interest None.
| ACKNOWLEDGMENTS This work was part of Project of National Ministry of Industry and Information, National Health and Family Planning Commission of the People’s Republic of China No.2016MDHD11002101 |
| Received 2017-12-03 |
| Accepted 2018-01-05 |
| DOI: 10.12015/issn.1674-8034.2018.02.005 |
| DOI:10.12015/issn.1674-8034.2018.02.005. |
[1]
Abdominal Study Group, Chinese Society of Radiology, Chinese Medical Association. Expert consensus on clinical application of hepatobiliary: specific MRI contrast agent Gd-EOB-DTPA．Chin J Radiol, 2016, 50(9): 641-646.中华医学会放射学分会腹部学组．肝胆特异性MRI对比剂钆塞酸二钠临床应用专家共识．中华放射学杂志, 2016, 50(9): 641-646.
[2]
National Health and Family Planning Commission of the People's Republic of China. Diagnosis, management, and treatment of hepatocellular carcinoma (V2017). J Clin Hepatol, 2017, 33(8): 114-126.中华人民共和国国家卫生和计划生育委员会．原发性肝癌诊疗规范（2017年版）.临床肝胆病杂志, 2017, 33(8): 114-126.
[3]
Liang L, Chen CZ, Rao SX, et al. Study of clinical application of hepatic-biliary specific MR contrast agent(Gd-EOB-DTPA) in the diagnosis of focal hepatic lesions. Radiol Practice, 2012, 27(7): 765-770.梁亮，陈财忠，饶圣祥，等．肝胆特异性磁共振对比剂Gd-EOB-DTPA在肝脏局灶性病变诊断中的应用研究．放射学实践, 2012, 27(7): 765-770.
[4]
Tian Y, Liu PF, Sun P, et al. Value of delay of Gd-EOB-DTPA contrast-enhanced MRI in diagnosing focal liver lesions. J Harbin Med Univ, 2016, 50(4): 337-340.田园，刘鹏飞，孙鹏，等.钆塞酸二钠MR增强延迟期对肝脏局灶性病变的诊断价值．哈尔滨医科大学学报, 2016, 50(4): 337-340.
[5]
Qiao PF, Niu GM, Gao Y. The value of Gd-DTPA and Gd-EOB-DTPA in differential diagnosis of hepatic nodules. J Pract Radiol, 2015, 31(1): 83-86.乔鹏飞，牛广明，高阳. 2种磁共振对比剂动态增强扫描对肝内结节的鉴别诊断价值．实用放射学杂志, 2015, 31(1): 83-86.
[6]
Chen CZ, Rao SX, Ding Y, et al. Hepatocellular carcinoma 20 mm or smaller in cirrhosis patients: early magnetic resonance enhancement by gadoxetic acid compared with gadopentetate dimeglumine. Hepatol Int, 2014, 8(1): 104-111.
[7]
Kogita S, Imai Y, Okada M, et al. Gd-EOB-DTPA-enhanced magnetic resonance images of hepatocellular carcinoma:correlation with histological grading and portal blood flow. Eur Radiol, 2010, 20(10): 2405-2413.
[8]
Cai HS, Wu L, Hu XS, et al. Application of Gd-EOB-DTPA- enhanced MRI in the diagnosis of cholangiocarcinoma. Diagnostic Imaging and Interventional Radiol, 2013, 22(5): 353-357.蔡华崧，伍玲，胡晓书，等. Gd-EOB-DTPA增强磁共振成像在胆管癌诊断的应用．影像诊断与介入放射学, 2013, 22(5): 353-357.
[9]
Yeh MM. Pathology of combined hepatocellular-cholangiocarcinoma. J Gastroenterolhepatology, 2010, 25(9): 1485-1492.
[10]
Li YL, Wu XR. CT and MRI findings of combined hepatocellular carcinoma and cholangiocarcinoma. Chin J Radiol, 2012, 46(8): 701-704.李英丽，吴秀蓉．混合型肝癌的CT和MRI表现．中华放射学杂志, 2012, 46(8): 701-704.
[11]
Wang Y, Xiao XJ, Yu SP, et al. Diagnostic value of Gd-EOB-DTPA in hepatic focal nodular hyperplasia. J Sun Yat-Sen University, 2015, 36(3): 269-274.王影，肖晓娟，余深平，等. Gd-EOB-DTPA对肝局灶性结节增生的诊断价值探讨．中山大学学报（医学科学版）, 2015, 36(2): 269-274.
[12]
Zhang JY, Lu J, Zhang XQ, et al. The value of Gd-EOB-DTPA enhanced MRI in diagnosis of focal nodular hyperplasia of liver. J Pract Radiol, 2017, 33(8): 1304-1306.张继云，陆健，张学琴，等. Gd-EOB-DTPA增强MRI诊断肝局灶性结节增生的价值．实用放射学杂志, 2017, 33(8): 1304-1306.
[13]
Campos JT, Sirlin CB, Choi JY. Focal hepatic lesions in Gd-EOB-DTPA enhanced MRI: the atlas. Insights Imaging, 2012, 3(5): 451-474.
[14]
Sun X, Jin EH, Yang ZH. The Gd-EOB-DTPA enhanced MRI features of hepatic angiomyolipoma and literature review. Int J Med Radiol, 2017, 40(4): 450-455.孙侠，靳二虎，杨正汉．肝脏血管平滑肌脂肪瘤的钆塞酸二钠增强MRI表现及文献复习．国际医学放射学杂志, 2017, 40(4): 450-455.
[15]
Kim R, Lee J M, Joo I, et al. Differentiation of lipid poor angiomyolipoma from hepatocellular carcinoma on gadoxetic acid-enhanced liver MR imaging. Abdom Imaging, 2015, 40(3): 531-541.
