慢性肝病肝功能正常或Child-Pugh A级患者增强CT与
普美显增强MRI诊断HCC流出征象观察期相选择

doi:10.12117/jccmi.2018.11.004

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Abstract Objective: To compare the diagnostic performance of washout appearance on portal venous phase or delayed phase(transitional phase) for hepatocellular carcinoma(HCC) between gadolinium-ethoxybenzyl-diethylenetriaminpentaacetic acid (Gd-EOB-DTPA)-enhanced MRI and contrast enhanced CT in patients with chronic liver disease and normal liver function or Child-Pugh grade A. Methods: Retrospective analysis of preoperative imaging data of patients with normal liver function or Child-Pugh grade A and pathologically confirmed HCC or non-HCC lesions from January 2015 to July 2017, including 83 patients with contrast enhanced CT and 54 patients with Gd-EOB-DTPA-enhanced MRI, was performed. The arterial phase enhancement and portal venous, and delayed/transitional phase washout appearance of each lesion were observed and recorded by two radiologists on the same workstation. The Mann-Whitney test was used to compare the differences in age and lesion size between contrast enhanced CT and Gd-EOB-DTPA-enhanced MRI groups. The Kappa test was used to analyze the consistency of characteristic evaluation of each lesion between two radiologists. The Chi-Square test or Fisher’s exact test was used to compare the sex distribution, pathological results, and arterial phase enhancement characteristic of different lesions. ROC curve was performed to compare the diagnostic performance of arterial phase enhancement combined with washout appearance in portal venous and delayed/transitional phase for HCC between two groups. Results: There was no statistical difference in the distribution of pathological results and the enhancement characteristics of arterial phase between the two groups(P all >0.05). In the contrast enhanced CT group, the AUC value of diagnosis HCC was 0.910 when the arterial phase enhancement combined with washout appearance on portal venous phase(sensitivity: 85.14%, specificity: 96.77%), and the AUC value was 0.849 when arterial phase enhancement combined with washout appearance on delayed phase(sensitivity: 89.19%, specificity: 80.65%), the difference of the AUC values was not statistically significant(P=0.089 0). In Gd-EOB-DTPA-enhanced MRI group, the AUC of diagnosing HCC value was 0.853 when the arterial phase enhancement combined with washout appearance of portal venous phase(sensitivity: 76.09%, specificity: 94.44%), and the AUC value was 0.729 when the arterial phase enhancement combined with washout appearance in transitional phase(sensitivity: 84.78%, specificity: 61.11%), and the difference of AUC values was statistically significant(P=0.043 1). Conclusion: In patients with chronic liver disease and normal liver function or Child-Pugh grade A, washout appearance observed on portal venous and delayed phase for HCC have similar diagnostic accuracy on contrast enhanced CT, but washout appearance observed on portal venous are more accurate than transitional phase on Gd-EOB-DTPA-enhanced MRI.

Key words： Carcinoma, hepatocellular Tomography, spiral computed

Received: 11 August 2018

PACS:	Ｒ735.7
	Ｒ814.42

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	Articles by authors
	FAN Lu-lu1
	XIE Shuang-shuang2
	ZHANG Kun2
	LI Qing2
	SHEN Wen2

Cite this article:

FAN Lu-lu1,XIE Shuang-shuang2,ZHANG Kun2, et al. Phase selection for observing washout appearance in diagnosing hepatocellular carcinoma in contrast enhanced CT and Gd-EOB-DTPA-enhanced MRI for chronic liver disease patients with normal liver function or Child-Pugh grade A[J]. JOURNAL OF CHINA MEDICAL IMAGING, 2018, 29(11): 775-781.

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http://www.jccmi.com.cn/EN/10.12117/jccmi.2018.11.004 OR http://www.jccmi.com.cn/EN/Y2018/V29/I11/775

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