| 1 | MRI versus 64-row MDCT for diagnosis of hepatocellular carcinoma显示文摘AIM:To compare the diagnostic capability of multidetector computed tomography(MDCT) and magnetic resonance imaging(MRI) for the detection of hepatocellular carcinoma(HCC) tumour nodules and their effect on patient management.METHODS:A total of 28 patients(25 male,3 female,mean age 67±10.8 years) with biopsy-proven HCC were investigated with 64-row MDCT(slice 3 mm native,arterial and portal-venous phase,120 mL Iomeprol,4 mL/s,delay by bolus trigger) and MRI(T1fs fl2d TE/ TR 2.72/129 ms,T2tse TE/TR 102/4000 ms,5-phase dynamic contrast-enhanced T1fs fl3d TE/TR 1.56/4.6,Gadolinium-DTPA,slice 4 mm).Consensus reading of both modalities was used as reference.Tumour nodules were analyzed with respect to number,size,and location.RESULTS:In total,162 tumour nodules were detected by consensus reading.MRI detected signifi cantly more tumour nodules(159 vs 123,P<0.001) compared to MDCT,with the best sensitivity for early arterial phase MRI.False-negative CT findings included nodules ≤5 mm(n=5),≤10 mm(n=17),≤15 mm(n=12),≤20 mm(n=4),and 1 nodule >20 mm.MRI missed 2 nodules ≤10 mm and 1 nodule ≤15 mm.On MRI,nodule diameters were greater than on CT(29.2±25.1 mm,range 5-140 mm vs 24.1±22.7 mm,range 4-129 mm,P<0.005).In 2 patients,MDCT showed only unilobar tumour spread,whereas MRI revealed additional nodules in the contralateral lobe.Detection of these nodules could have changed the therapeutic strategy.CONCLUSION:Contrast-enhanced MRI is superior to 64-row MDCT for the detection of HCC nodules.Patients should be allocated to interventional or operative treatment according to a dedicated MRI-protocol. | Michael Bernhard Pitton Roman Kloeckner Sascha Herber Gerd Otto Karl Friedrich Kreitner Christoph Dueber | 2009 | World Journal of Gastroenterology2009，15，48： | 5 |
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