A study of primovist in distinguishing transient hepatic parenchymal enhancement from small hepatocellular carcinoma and a comparison with non-specific contrast agent
WANG Ai-bo1, LUO Jia-wen1, BIAN Jie1, LIU Jun2, CHEN Hong-hai1, ZHAI Fang-bing1, LIU Ya-jie1, YU Chuan-wen1, ZHANG Xi-you1
1. Department of Radiology, the Second Hopital of Dalian Medical University, Dalian Liaoning 116000, China;
2. Department of Radiology, the Central Hopital of Dalian, Dalian Liaoning 116033, China
Abstract Objective: To compare the ability of hepatocyte specific contrast agent Gd-EOB-DTPA with non-specific extracellular contrast agent Gd-DTPA in differential diagnosis of transient hepatic parenchymal enhancement(THPE) and small hepatocelluar carcinoma(small HCC). And to analyze the lesion shape, signal intensity, and enhancement pattern with two agents. Methods: Two radiologists analyzed the imaging characteristics of 58 focal liver lesions(FLL) from 46 patients with cirrhosis. The analysis focused on morphology, signal intensity and the patterns of enhancement in different phases with Gd-DTPA and Gd-EOB-DTPA respectively, and then the property of each focal liver lesion was inferred and compared with the final results. A retrospective analysis about the ability of two contrast mediums in detection and differential diagnosis of THPE and small HCC was performed with pathologic findings, angiography or follow-up over 6 months as reference and gold standard. The Chi-square test was used for comparisons of shape, location, signal intensity and pattern of enhancement between THPE and small HCC, comparison of enhancement pattern of THPE with the two MRI contrast agents, and comparison of enhancement pattern of small HCC with the two MRI contrast agents. Sensitivities, specificities and AUCs(area under curve) of ROCs of the two agents were figured out in the groups of total 58 FLL, 36 nodular FLL and 23 FLL whose maximum diameter＜1 cm, respectively, and thus calculating their diagnostic performance. Significance was set at P＜0.05. Among 39 THPEs, there were 33 cases confirmed by 6 months’ following up, and others were confirmed by angiography. Among 19 small HCCs, 10 cases were confirmed by postoperative pathology, 1 case was identified by percutaneous biopsy and angiography, and other 8 cases were confirmed by combining gangiography and AFP. Results: In different groups, the sensitivity, specificity and the AUC of Gd-EOB-DTPA were all higher than those of Gd-DTPA. Significant differences in shape, location, signal intensity and patterns of enhancement were observed between THPE and small HCC(P＜0.05). The patterns of enhancement of THPE with two agents showed no difference(P＞0.05), and the patterns of enhancement of small HCC with two agents showed no difference too. Conclusion: ①In magnetic resonance imaging(MRI), there are significant differences in shape, signal intensity, location and patterns of enhancement between THPE and small HCC, while the two MRI contrast agents show no statistical difference in the enhancement pattern of all focal liver lesions. ②Gd-EOB-DTPA has more advantages in distinguishing THPE from small HCC so it has a higher diagnostic performance than traditional contrast agent.
WANG Ai-bo1,LUO Jia-wen1,BIAN Jie1, et al. A study of primovist in distinguishing transient hepatic parenchymal enhancement from small hepatocellular carcinoma and a comparison with non-specific contrast agent[J]. JOURNAL OF CHINA MEDICAL IMAGING, 2016, 27(12): 881-887.
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