Şehnaz EVRIMLER, Ayşe SAY, Adnan KARAIBRAHIMOGLU, Mustafa KAYAN

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

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

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

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.

Keywords:

liver, hepatocellular carcinoma, contrast, quantitative,

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