Diagnosis of liver metastases: Can diffusion-weighted imaging (DWI) be used as a stand alone sequence?

详细信息	查看全文 | 推荐本文 |

• 作者：Christoph Kenis^a ; ^b ; ^{christophkenis@hotmail.com} ; Filip Deckers^a ; Bert De Foer^a ; Fran&ccedil ; ois Van Mieghem^a ; Steven Van Laere^c ; Marc Pouillon^a
• 关键词：Diffusion magnetic resonance imaging ; Liver neoplasms ; Metastases ; Gadolinium ; Contrast media
• 刊名：European Journal of Radiology
• 出版年：2012
• 期刊代码：93_0720048x
• 类别：med
• 出版时间：May, 2012
• 卷：81
• 期：5
• 页码：1016-1023
• 文件大小：927 K

摘要

ass="h4">Objectives

To evaluate if diffusion-weighted MRI (DWI) can replace gadolinium-enhanced MRI (Gd-MRI) for diagnosing liver metastases. The diagnostic accuracy of both techniques alone and in combination are compared.

ass="h4">Materials and methods

Sixty-eight patients with histologically proven primary extrahepatic tumors were included in this retrospective study. Lesions included 62 metastases and 130 benign lesions. Three image sets (unenhanced T1 and T2/gadolinium enhanced T1 (Gd-MRI), DWI and combination of both) were reviewed independently by 3 observers. The areas under the receiver operating characteristic curves (A_z), sensitivity and specificity for the 3 image sets were compared. The standard of reference was either histopathology or multi-modality and clinical follow-up.

ass="h4">Results

Pooled data showed higher diagnostic accuracy for the combined set (A_z = 0.93) compared to Gd-MRI (p = 0.001) and DWI (p < 0.0001). No difference was found between the performance of Gd-MRI and DWI (p = 0.09). Sensitivity for the combined set was higher than Gd-MRI (p = 0.0003) and DWI (p = 0.0034). Specificity for DWI was lower than Gd-MRI (p < 0.0001) and the combined set (p < 0.0001).

ass="h4">Conclusion

The diagnostic performance of DWI is equal to that of Gd-MRI. DWI alone can be used in patients where gadolinium contrast administration is not allowed. Combination of Gd-MRI and DWI significantly increases diagnostic accuracy.