Added value of Gd-EOB-DTPA-enhanced Hepatobiliary phase MR imaging in evaluation of focal solid hepatic lesions

BMC Medical Imaging

Research Article

Ivan Platzek¹  Michael Haimerl²  Max Wächtler²  Andreas Georg Schreyer²  Christian Stroszczynski²  Rene Müller-Wille²  Christoph Niessen²  Patrick Hoffstetter²  Philipp Wiggermann² 

[1] Department of Radiology, University Hospital Carl Gustav Carus Dresden, Dresden, Germany;Department of Radiology, University Medical Center Regensburg, 93042, Regensburg, Germany;

关键词: Magnetic resonance imaging;    Focal hepatic lesions;    Gd-EOB-DTPA-enhanced MR imaging;    Hepatobiliary;    Diagnostic performance;    Characterization;   

DOI  :  10.1186/1471-2342-13-41

 received in 2013-04-02, accepted in 2013-11-26,  发布年份 2013

来源: Springer

【 摘 要 】

BackgroundCorrect characterization of focal solid hepatic lesions has always been a challenge and is of great diagnostic and therapeutic relevance. The purpose of this study was to determine the added value of hepatobiliary phase images in Gd-EOB-DTPA-enhanced magnetic resonance imaging (MRI) for differentiating focal solid hepatic lesions.MethodsIn this retrospective trial 84 consecutive patients underwent Gd-EOB-DTPA-enhanced MR examinations. MRI was conducted for 64 patients with malignant focal hepatic lesions (34 hepatocellular carcinoma (HCC), 30 metastases) and for 20 patients with benign hepatic lesions (14 focal nodular hyperplasia (FNH), 3 adenoma, 3 hemangioma). Five radiologists independently reviewed three sets of MR images by means of a 5-point confidence scale from score 1 (definitely benign) to score 5 (definitely malignant): set 1: unenhanced images; set 2: unenhanced and Gd-EOB-DTPA-enhanced dynamic images; set 3: hepatobiliary phase images in addition to set 2. Accuracy was assessed by the alternative free-response receiver operating characteristic curve (Az) and the index of diagnostic performance was calculated.ResultsDiagnostic accuracy was significantly improved by the addition of Gd-EOB-DTPA-enhanced dynamic images: Az in set 1 was 0.708 and 0.833 in set 2 (P = 0.0002). The addition of hepatobiliary phase images increased the Az value to 0.941 in set 3 (set 3 vs set 2, P < 0.0001; set 3 vs set 1, P < 0.0001). The index of diagnostic performance was lowest in set 1 (45%), improved in set 2 (71%), and highest in set 3 (94%).ConclusionsHepatobiliary phase images obtained after Gd-EOB-DTPA-enhanced dynamic MRI improve the differentiation of focal solid hepatic lesions.

【 授权许可】

CC BY   
© Haimerl et al.; licensee BioMed Central Ltd. 2013