The Value of Gadopentetate Disodium-Enhanced Magnetic Resonance Transitional and Hepatobiliary Phase Low Signal for the Diagnosis of Hepatocellular Carcinoma
Objective To investigate the diagnostic value of Gd-EOB-DTPA-enhanced MRI transition phase and hepa-tobiliary phase low signal for hepatocellular carcinoma.Methods A total of 178 nodules from 129 patients confirmed by pathology or clinical follow-up were included in the study among patients who underwent Gd-EOB-DTPA-enhanced MRI in the Affiliated Hospital of Guilin Medical College between January 2020 and April 2022.Two doctors independently evalua-ted and labeled each nodular imaging sign,and statistically analyzed the diagnostic efficacy of two diagnostic models for hep-atocellular carcinoma,the first model was"arterial phase hyperenhancement(APHE)and portal venous phase washout",and the second model was"APHE,portal venous phase or transitional phase(TP)or hepatobiliary phase transitional phase(HBP)washout".Results The sensitivity and accuracy with washout extended to the transitional phase and the hepato-biliary phase[93.80％(121 of 129),87.08％(155 of 178)]was better than that with washout confined to the portal ve-nous phase[74.42％(96 of 129),76.97％(137 of 178);P＜0.05].The difference is more pronounced when the diameter of the nodules is less than or equal to 3 cm.When the DWI was combined,the specificity with extensions of washout to the transitional phase and hepatobiliary phase[85.71％(42 of 49)]was similar to that obtained with washout confined to the portal venous phase[87.76％(43 of 49);P=1.000].Conclusion Gd-EOB-DTPA-enhanced MRI has high diagnostic efficacy for hepatocellular carcinoma.The replacement of portal phase clearance with low signal in the transitional or hepa-tobiliary phase as a new diagnostic model can significantly improve the sensitivity of diagnosing HCC.Combined with DWI,the diagnostic efficiency is further improved.
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