The Quantitative Evaluation of Primary Liver Lesions on Hepatocyte Specific Contrast Enhanced Magnetic Resonance Imaging

Yıl 2020, Cilt: 11 Sayı: 2, 178 - 185, 15.06.2020

Sehnaz Evrimler , Ayşe Say , Adnan Karaıbrahımoglu , Mustafa Kayan

Öz

Introduction: Most
of the previous researchers evaluated contrast-noise ratio, SI lesion/SI liver
parenchyma, and DWI in their studies for quantitative analysis of liver
lesions. We aimed to
investigate the diagnostic value of the quantitative measurements with new formulas
calculated on Gd-EOB-DTPA enhanced DCE-MR images with 30° and 10° FA
at the hepatobiliary phase and DWI.

Material-Methods: There
was a total of 54 primary liver lesions; n=23 HCC in the malignant group and
n=19 hemangioma, n=6 FNH, n=3 hepatic adenoma, n=3 dysplastic nodule in the
benign group. Relative contrast enhancement 
[RCE= (HBP-Pre)/Pre], absolute contrast enhancement [ACE= (SI lesion- SI
liver)/ SI paravertebral muscle], absolute washout [AW=(AP-HBP)/(AP-Pre)],
relative washout (RW=AP-HBP/AP) and ADC values were calculated.

Results: There was a significant difference in the quantitative
measurements among the liver lesion groups. HCC demonstrated significantly
higher AW and RW, lower ACE and RCE values than the benign group. The ICC
values between the two FA measurements were good for RCE and RW, but not for
ACE and AW. HCC demonstrated significantly lower ADC values than the benign
group. According to ROC analysis, cut-off values for HCC were calculated [ACE;
-3.5 (sensitivity 100%, specificity 45.6%, accuracy 68.5 %), AW; 0.53
(sensitivity 87%, specificity 51.6%, accuracy 66.7%), RW; 0.105 (sensitivity 95.7%,
specificity 48.4%, accuracy 68.5%), RCE; -0,03 (sensitivity 73.9%, specificity 67.7%,
accuracy 70.4%), ADC; 1.09 (sensitivity 73.9%, specificity 74.2%, accuracy 74.1%)].

Conclusion: We suggest
that our quantitative measurements and DWI can be useful in differentiation
between HCC and other benign lesions in conflicting cases.

Anahtar Kelimeler

liver, hepatocellular carcinoma, contrast, quantitative

The Quantitative Evaluation of Primary Liver Lesions on Hepatocyte Specific Contrast Enhanced Magnetic Resonance Imaging

Öz

Giriş: Daha önce
araştırmacılar kontrast-gürültü oranı, SI lezyon/SI karaciğer parankimi ve
DAG’yi karaciğer lezyonlarının kantitatif değerlendirmesi için kullanmışlardır.
Biz çalışmamızda Gd-EOB-DTPA kontrast ajanlı DCE-MRG’de 30° ve 10° FA
ile çekilmiş hepatobiliyer faz görüntülerde yeni oluşturduğumuz formülleri
kullanarak ve DAG inceleme ile yapılan kantitatif değerlendirmenin primer
karaciğer lezyonları için tanısal değerini araştırmayı amaçladık.

Gereç ve Yöntem: 54 primer karaciğer
lezyonu; malign grupta n=23 HCC, benign grupta
n=19 hemangioma, n=6 FNH, n=3 hepatik adenom, n=3 displastik nodül çalışmaya
dahil edildi. Relatif kontrastlanma [RCE= (HBP-Pre)/Pre],  mutlak kontrastlanma [ACE= (SI lezyon- SI
karaciğer)/ SI paravertebral kas], mutlak yıkanma [AW=(AP-HBP)/(AP-Pre)],
relatif yıkanma (RW=AP-HBP/AP) ve ADC değerleri hesaplandı. 

Bulgular: Karaciğer lezyon grupları arasında kantitatif ölçümlerde
anlamlı farklılık bulundu. HCC benign gruba göre daha yüksek AW and RW, düşük
ACE ve RCE değerleri gösterdi. İki FA ölçümleri arasında ICC değerleri RCE ve
RW ölçümleri için iyi iken, ACE ve AW değerleri için değildi. HCC benign gruba
göre daha düşük ADC değerleri gösterdi. ROC analizine göre; HCC için hesaplanan
kesme değerleri şu şekildedir; [ACE; -3.5 (duyarlılık %100, özgüllük %45.6, doğruluk
%68.5), AW; 0.53 (duyarlılık %87, özgüllük %51.6, doğruluk %66.7), RW; 0.105 (duyarlılık
%95.7, özgüllük %48.4, doğruluk %68.5), RCE; -0,03 (duyarlılık %73.9, özgüllük
%67.7, doğruluk %70.4), ADC; 1.09 (duyarlılık %73.9, özgüllük %74.2, doğruluk %74.1)].

Sonuç: Kantitatif ölçüm
ve DAG’nin arada kalınılan olgularda HCC ve benign karaciğer lezyon ayrımında
yararlı olacağını düşünmekteyiz. 

Anahtar Kelimeler

hepatoselüler karsinom, kantitatif, karaciğer, kontrast

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