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首页> 外文期刊>Journal of magnetic resonance imaging: JMRI >Added value of breathhold diffusion-weighted MRI in detection of small hepatocellular carcinoma lesions compared with dynamic contrast-enhanced MRI alone using receiver operating characteristic curve analysis.
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Added value of breathhold diffusion-weighted MRI in detection of small hepatocellular carcinoma lesions compared with dynamic contrast-enhanced MRI alone using receiver operating characteristic curve analysis.

机译：与仅使用接受者工作特征曲线分析进行动态对比增强MRI相比，屏气弥散加权MRI在检测小肝细胞癌病变中的附加价值。

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PURPOSE: To evaluate the added value of single-breathhold diffusion-weighted MRI (DWI) in detection of small hepatocellular carcinoma (HCC) lesions (< or =2 cm) in patients with chronic liver disease, by comparing the detection sensitivity of combined DWI/conventional dynamic contrast-enhanced (DCE)-MRI to that of conventional DCE-MRI alone. MATERIALS AND METHODS: A total of 37 patients with chronic liver diseases underwent abdominal MRI at 1.5T, including T1-weighted imaging (T1WI), T2-weighted imaging (T2WI), and 2D conventional DCE. For each patient study, axial DWI was performed with a single-shot echo-planar imaging (EPI) sequence using a modified sensitivity-encoding (mSENSE) technique with b-value of 500 seconds/mm(2). A total of 20-24 slices were obtained during a 15-17-second breathhold. Two observers independently interpreted the combined DWI/conventional DCE-MRI images and the conventional DCE-MRI images alone in random order. For all small HCC lesions, the diagnostic performance using each imaging set was evaluated by receiver operating characteristic (ROC) curve analysis. Sensitivity and positive predictive values were also calculated and analyzed. RESULTS: A total of 47 small HCCs were confirmed as final result. The area under the ROC curve (Az) of combined DWI/conventional DCE-MRI images (observer 1, 0.922; observer 2, 0.918) were statistically higher than those of conventional DCE-MRI alone (observer 1, 0.809; observer 2, 0.778) for all small HCC lesions (P < 0.01). The lesion detection sensitivities using the combined technique for both observers were significantly higher than those using conventional DCE-MRI alone (P < 0.01). The sensitivity values for two observers using the combined technique were 97.87% and those using conventional DCE-MRI alone were 85.11% to 82.98%. The positive predictive values for two observers using the combined imaging technique (97.87%) were slightly higher than those using conventional DCE-MRI alone (92.86-93.02%), but there was no significant difference between the two imaging sets. CONCLUSION: Combined use of breathhold DWI with conventional DCE-MRI helped to provide higher sensitivities than conventional DCE-MRI alone in the detection of small HCC lesions in patients with chronic liver disease.
机译：目的：通过比较联合DWI的检测灵敏度，评估单屏弥散加权MRI（DWI）在慢性肝病患者小肝细胞癌（HCC）病变（<或= 2 cm）检测中的附加价值/常规动态对比增强（DCE）-MRI与仅常规DCE-MRI相比。材料与方法：共有37例慢性肝病患者在1.5T时接受了腹部MRI，包括T1加权成像（T1WI），T2加权成像（T2WI）和2D常规DCE。对于每项患者研究，均采用改良的灵敏度编码（mSENSE）技术以b值为500秒/ mm的单次回波平面成像（EPI）序列进行轴向DWI（2）。在15-17秒的屏气期间总共获得了20-24片。两名观察员以随机顺序分别解释了组合的DWI /常规DCE-MRI图像和常规DCE-MRI图像。对于所有小的HCC病变，通过接收器工作特征（ROC）曲线分析评估了使用每个成像装置的诊断性能。还计算并分析了敏感性和阳性预测值。结果：总共47个小型肝癌被确认为最终结果。 DWI /常规DCE-MRI组合图像的ROC曲线下面积（Az）（观察者1，0.922;观察者2，0.918）在统计学上高于单独的常规DCE-MRI（观察者1，0.809;观察者2，0.778） ）适用于所有小的HCC病变（P <0.01）。使用组合技术对两位观察者进行的病变检测敏感性明显高于单独使用常规DCE-MRI的病变敏感性（P <0.01）。使用组合技术的两名观察员的敏感度值为97.87％，仅使用常规DCE-MRI的敏感度为85.11％至82.98％。使用组合成像技术的两名观察者的阳性预测值（97.87％）比仅使用常规DCE-MRI的阳性预测值（92.86-93.02％）略高，但是两组成像之间没有显着差异。结论：将呼吸暂停DWI与常规DCE-MRI结合使用可比慢性DCE-MRI单独提供更高的灵敏度，可用于检测慢性肝病患者的小HCC病变。

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