ABSTRACT
A caracterização das lesões hepáticas focais é muito importante. A ressonância magnética é considerada o melhor método de imagem para a avaliação destas lesões, mas não permite o diagnóstico em todos os casos. Os contrastes hepatobiliares aumentam a acurácia diagnóstica da ressonância magnética e diminuem o número de lesões hepáticas indefinidas. Suas principais indicações são a diferenciação entre hiperplasia nodular focal e adenoma, caracterização de carcinoma hepatocelular em pacientes cirróticos, detecção de metástases hepáticas pequenas, avaliação da anatomia biliar e identificação de fístulas biliares pós-operatórias. A utilização dos contrastes hepatobiliares pode reduzir a necessidade de procedimentos diagnósticos invasivos e de avaliação complementar por outros exames de imagem, além de diminuir a necessidade de exames de acompanhamento.
The characterization of focal liver lesions is very important. Magnetic resonance imaging is considered the best imaging method for evaluating such lesions, but does not allow for the diagnosis in all cases. The use of hepatobiliary contrast agents increases the diagnostic accuracy of magnetic resonance imaging and reduces the number of non-specific liver lesions. The main indications for the method include: differentiation between focal nodular hyperplasia and adenoma; characterization of hepatocellular carcinomas in cirrhotic patients; detection of small liver metastases; evaluation of biliary anatomy; and characterization of postoperative biliary fistulas. The use of hepatobiliary contrast agents may reduce the need for invasive diagnostic procedures and further investigations with other imaging methods, besides the need for imaging follow-up.
ABSTRACT
Objective To compare the role of Gd-EOB-DTPA dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) with multi-detector row computed tomography (MDCT),and to determine the sensitivity,specificity and accuracy in focal hepatic lesions.Methods A retrospective analysis was conducted on 32 patients with focal hepatic lesions who had undergone MRI and MDCT examinations.These patients were divided into two groups:the CT group and the MRI group.The results were analysed using receiver operating characteristic (ROC) curves.Result There were 185 focal hepatic lesions.The sensitivity,specificity and the area under the ROC curve (AUC) were 86.5％,90.9％,0.855,respectively for the MRI group and they were significantly higher than the CT group (63.6％,54.5％,0.532).For detection of lesions ＜1 cm,the sensitivity,specificity and the area under the ROC curve (AUC) for the MRI group were 90％,86.6％,0.886,respectively,which were also significantly higher than the CT group (50.5％,45.5％,0.500).When combined with pathological findings and follow-up,the diagnostic accuracy was 40.6％ using Gd-EOB-DTPA DCE-MRI.Conclusion Gd-EOB-DTPA DCE-MRI has a higher detection rate,better accuracy and diagnostic value for focal liver lesions (＜1 cm) than MDCT.
ABSTRACT
Objective To study the diagnostic value of contrast-enhanced CT patterns in focal hepatic lesions.Methods Contrast-enhanced CT patterns in 44 patients with focal hepatic lesions (54 foci) were retrospectively analysed.Results (1)78% of the hepatocellular carcinoma presented "rapid-filling and rapid-washout" feature.(2)All hepatic hemangioma presented "rapid-filling and slow-washout", progressive opacification from the periphery to center. (3)All cholangiocarcinoma presented "slow-filling and slow-washout" .(4)Metastatic hepatocarcinoma in 14 cases and hepatic abscesses in 5 cases were presented a enhanced ring around the lesion, metastatic hepatocarcinomas showed single ring,however, hepatic abscesses showed multi-ring. (5)Focal nodular hyperplasia in 3 cases and hepatic adenomas in 1 case presented "rapid-filling and slow-washout".Conclusion The contrast-enhanced patterns at spiral CT can fully reflect the blood supply of focal hepatic lesions, it has significant value in diagnosing focal hepatic lesions.