AIM: To compare the gadolinium-enhanced multiphase dynamic magnetic resonance imaging (MRI) and multiphase multirow-detector helical CT (MDCT) scanning for detection of small hepatocellular carcinoma (HCC). METHODS: M...AIM: To compare the gadolinium-enhanced multiphase dynamic magnetic resonance imaging (MRI) and multiphase multirow-detector helical CT (MDCT) scanning for detection of small hepatocellular carcinoma (HCC). METHODS: MDCT scanning and baseline MRI with SE T1-WI and T2-WI sequence combined with FMPSPGR sequence were performed in 37 patients with 43 small HCCs. Receiver operating characteristic (ROC) curves were plotted to analyze the results for modality. RESULTS: The areas below ROC curve (Az) were calculated. There was no statistical difference in dynamic enhancement MDCT and MRI. The detection rate of small HCC was 97.5%-97.6% on multiphase MDCT scanning and 90.7%-94.7% on MRI, respectively. The sensitivity of detection for small HCC on MDCT scanning was higher than that on dynamic enhancement MRI. The sensitivity of detection for minute HCC (tumor diameter ≤ 1 cm) was 90.0%-95.0% on MDCT scanning and 70.0%-85.0% on MRI, respectively. CONCLUSION: MDCT scanning should be performed for early detection and effective treatment of small HCC in patients with chronic hepatitis and cirrhosis during follow-up.展开更多
AIM: To investigate the hemodynamic changes in a precancerous lesion model of hepatocellular carcinoma (HCC). METHODS: Hemodynamic changes in 18 Wistar rats were studied with non-invasive magnetic resonance (MR) perfu...AIM: To investigate the hemodynamic changes in a precancerous lesion model of hepatocellular carcinoma (HCC). METHODS: Hemodynamic changes in 18 Wistar rats were studied with non-invasive magnetic resonance (MR) perfusion. The changes induced by diethylnitrosamine (DEN) developed into liver nodular lesions due to hepatic cirrhosis during the progression of carcinogenesis. The MR perfusion data [positive enhancement integral (PEI)] were compared between the nodular lesions corresponding well with MR images and pathology and their surrounding hepatic parenchyma. RESULTS: A total of 46 nodules were located by MR imaging and autopsy, including 22 dysplastic nodules (DN), 9 regenerative nodules (RN), 10 early HCCs and 5 overt HCCs. Among the 22 DNs, 6 were low-grade DN (lGDN) and 16 were high-grade DN (HGDN). The average PEI of RN, DN, early and overt HCC was 205.67 ± 31.17, 161.94 ± 20.74, 226.09 ± 34.83, 491.86 ± 44.61 respectively, and their liver parenchyma nearby was 204.84 ± 70.19. Comparison of the blood perfusion index between each RN and its surrounding hepatic parenchyma showed no statistically significant difference (P = 0.06). There were significant differences in DN (P = 0.02). During the late hepatic arterial phase, the perfusion curve in DN declined. DN had an iso-signal intensity at the early hepatic arterial phase and a low signal intensity at the portal venous phase. Of the 10early HCCs, 4 demonstrated less blood perfusion and 6 displayed minimally increased blood flow compared to the surrounding parenchyma. Five HCCs showed significantly increased blood supply compared to the surrounding parenchyma (P = 0.02). CONCLUSION: Non-invasive MR perfusion can detect changes in blood supply of precancerous lesions.展开更多
Objective: To evaluate the value of MR dynamic Gadolinium-enhanced fast multiplanar spoiled gradi- ent-echo (FMPSPGR) and spin-echo (SE) T1- weighted fat-suppressed techniques in the diagnosis of pancreatic carcinoma....Objective: To evaluate the value of MR dynamic Gadolinium-enhanced fast multiplanar spoiled gradi- ent-echo (FMPSPGR) and spin-echo (SE) T1- weighted fat-suppressed techniques in the diagnosis of pancreatic carcinoma. Methods: Eighteen cases of pancreatic carcinoma veri- fied by surgical and pathologic results were examined by MR, and the MR sequences included SE T1WI, FSE T2WI, SE T1-weighted fat-suppressed and dy- namic Gadolinium-enhanced FMPSPGR. Results: Of 18 pancreatic carcinomas, 10, 6, and 2 tumors showed respectively hypo-intensity, iso-inten- sity and hyper-intensity on SE T1WI, meanwhile, 8, 6, and 4 tumors displayed hyper-intensity, iso-inten- sity and hypo-intensity on FSE T2WI in comparison with the normal pancreatic tissue. All of the tumors showed hypo-intensity on SE T1-weighted fat-sup- pressed and also obvious non-enhancement or slight enhancement on MR dynamic Gadolinium-enhanced FMPSPGR images during the arterial dominant phase scanning. Conclusion: SE T1-weighted fat-suppressed and MR dynamic Gadolinium-enhanced FMPSPGR sequences could evidently improve the sensitivity and specificity in the diagnosis of pancreatic carcinoma.展开更多
Objectives: To study prospectively the enhancement features of small hepatocellular carcinoma (SHCC) with multi-phase scanning of dynamic MRI and spi- ral CT, and discuss the superiority of dynamic MRI to spiral CT. M...Objectives: To study prospectively the enhancement features of small hepatocellular carcinoma (SHCC) with multi-phase scanning of dynamic MRI and spi- ral CT, and discuss the superiority of dynamic MRI to spiral CT. Methods: Multi-phase dynamic contrast scanning of high field MRI and spiral CT were performed in 53 patients with SHCC. The arterial phase, portal ve- nous phase and delayed phase scanning of spiral CT was done after the pre-contrast scanning of the entire liver. MRI was performed with SE sequence and fast multiplanar spoiled gradient-recalled sequence dy- namic multi-phase contrast scanning. Results: Seventy-six lesions were found in all 53 pa- tients. Sixty-nine and 54 of the 76 lesions enhanced obviously in MRI and spiral CT arterial phase scan- ning respectively. The typical enhancement patterns of SHCC in the arterial phase, portal venous phase and delayed phase scanning of MRI and spiral CT were hyper-hypo-hypointense (dense) and hyper-iso- hypointense (dense). Atypical enhancement patterns were hyper-hyper-hyperintense (dense), hyper-iso- isointense (dense) and hypo-hypo-hypointense (dense). Conclusions: Both MRI and spiral CT multi-phase dynamic contrast-enhanced scanning could demon- strate the enhancement features of SHCC, and arte- rial phase scan of MRI was superior to spiral CT in reflecting the hypervascular characterization of SHCC. In addition, MRI was better than spiral CT in characterization of hepatic lesions combined with SE sequence.展开更多
Objectives: To evaluate the value of the arterial phase(AP) of biphase enhanced spiral CT(SCT) in the di-agnosis of small HCC and to investigate the criteria,initial time, ending time and duration of AP.Methods: From ...Objectives: To evaluate the value of the arterial phase(AP) of biphase enhanced spiral CT(SCT) in the di-agnosis of small HCC and to investigate the criteria,initial time, ending time and duration of AP.Methods: From May 1995 to March 1999, patients withsmall HCC proved surgically and pathologically in-cluding 49 patients (n=53) in group A, 148 (n=186) ingroup B and 52 (n=52) in group C were collected.Biphase dynamic enhanced SCT scans were performedin all patients of the three groups and additional sin-gle-level dynamic scans only done in the group C. Thedetectability, diagnostic accuracy of lesions and en-hancement of the lesions in AP were analyzed statisti-cally. In addition, the initial time, ending time andduration of AP were measured.Results: The results of the group A showed the de-tectability of small HCC was 88.68% in AP and90.57% in both phases, higher than those by ultra-sound. Markedly enhanced lesions in AP accounted for76% and 78% in the groups B and C respectively. Theinitial time, ending time and duration of AP measuredon single-level dynamic scans were 16.9s, 39.6s and22.7s on average respectively.Conclusions: The biphase dynamic SCT especially itsarterial phase appears to be very valuable in diagnosingsmall HCCs. In light of short duration of AP, under-standing and strict control of AP is obviously impera-tive.展开更多
基金a financial assistance from Zhuhai Technology Bureau, No. PC20052025
文摘AIM: To compare the gadolinium-enhanced multiphase dynamic magnetic resonance imaging (MRI) and multiphase multirow-detector helical CT (MDCT) scanning for detection of small hepatocellular carcinoma (HCC). METHODS: MDCT scanning and baseline MRI with SE T1-WI and T2-WI sequence combined with FMPSPGR sequence were performed in 37 patients with 43 small HCCs. Receiver operating characteristic (ROC) curves were plotted to analyze the results for modality. RESULTS: The areas below ROC curve (Az) were calculated. There was no statistical difference in dynamic enhancement MDCT and MRI. The detection rate of small HCC was 97.5%-97.6% on multiphase MDCT scanning and 90.7%-94.7% on MRI, respectively. The sensitivity of detection for small HCC on MDCT scanning was higher than that on dynamic enhancement MRI. The sensitivity of detection for minute HCC (tumor diameter ≤ 1 cm) was 90.0%-95.0% on MDCT scanning and 70.0%-85.0% on MRI, respectively. CONCLUSION: MDCT scanning should be performed for early detection and effective treatment of small HCC in patients with chronic hepatitis and cirrhosis during follow-up.
基金the grants from Foundation of Ministry of Public Health of China, No. 20011420National Natural Science Foundation of China, No. 30470503
文摘AIM: To investigate the hemodynamic changes in a precancerous lesion model of hepatocellular carcinoma (HCC). METHODS: Hemodynamic changes in 18 Wistar rats were studied with non-invasive magnetic resonance (MR) perfusion. The changes induced by diethylnitrosamine (DEN) developed into liver nodular lesions due to hepatic cirrhosis during the progression of carcinogenesis. The MR perfusion data [positive enhancement integral (PEI)] were compared between the nodular lesions corresponding well with MR images and pathology and their surrounding hepatic parenchyma. RESULTS: A total of 46 nodules were located by MR imaging and autopsy, including 22 dysplastic nodules (DN), 9 regenerative nodules (RN), 10 early HCCs and 5 overt HCCs. Among the 22 DNs, 6 were low-grade DN (lGDN) and 16 were high-grade DN (HGDN). The average PEI of RN, DN, early and overt HCC was 205.67 ± 31.17, 161.94 ± 20.74, 226.09 ± 34.83, 491.86 ± 44.61 respectively, and their liver parenchyma nearby was 204.84 ± 70.19. Comparison of the blood perfusion index between each RN and its surrounding hepatic parenchyma showed no statistically significant difference (P = 0.06). There were significant differences in DN (P = 0.02). During the late hepatic arterial phase, the perfusion curve in DN declined. DN had an iso-signal intensity at the early hepatic arterial phase and a low signal intensity at the portal venous phase. Of the 10early HCCs, 4 demonstrated less blood perfusion and 6 displayed minimally increased blood flow compared to the surrounding parenchyma. Five HCCs showed significantly increased blood supply compared to the surrounding parenchyma (P = 0.02). CONCLUSION: Non-invasive MR perfusion can detect changes in blood supply of precancerous lesions.
文摘Objective: To evaluate the value of MR dynamic Gadolinium-enhanced fast multiplanar spoiled gradi- ent-echo (FMPSPGR) and spin-echo (SE) T1- weighted fat-suppressed techniques in the diagnosis of pancreatic carcinoma. Methods: Eighteen cases of pancreatic carcinoma veri- fied by surgical and pathologic results were examined by MR, and the MR sequences included SE T1WI, FSE T2WI, SE T1-weighted fat-suppressed and dy- namic Gadolinium-enhanced FMPSPGR. Results: Of 18 pancreatic carcinomas, 10, 6, and 2 tumors showed respectively hypo-intensity, iso-inten- sity and hyper-intensity on SE T1WI, meanwhile, 8, 6, and 4 tumors displayed hyper-intensity, iso-inten- sity and hypo-intensity on FSE T2WI in comparison with the normal pancreatic tissue. All of the tumors showed hypo-intensity on SE T1-weighted fat-sup- pressed and also obvious non-enhancement or slight enhancement on MR dynamic Gadolinium-enhanced FMPSPGR images during the arterial dominant phase scanning. Conclusion: SE T1-weighted fat-suppressed and MR dynamic Gadolinium-enhanced FMPSPGR sequences could evidently improve the sensitivity and specificity in the diagnosis of pancreatic carcinoma.
基金This study was financially supported by Ministry of Health of China (No. 97030220).
文摘Objectives: To study prospectively the enhancement features of small hepatocellular carcinoma (SHCC) with multi-phase scanning of dynamic MRI and spi- ral CT, and discuss the superiority of dynamic MRI to spiral CT. Methods: Multi-phase dynamic contrast scanning of high field MRI and spiral CT were performed in 53 patients with SHCC. The arterial phase, portal ve- nous phase and delayed phase scanning of spiral CT was done after the pre-contrast scanning of the entire liver. MRI was performed with SE sequence and fast multiplanar spoiled gradient-recalled sequence dy- namic multi-phase contrast scanning. Results: Seventy-six lesions were found in all 53 pa- tients. Sixty-nine and 54 of the 76 lesions enhanced obviously in MRI and spiral CT arterial phase scan- ning respectively. The typical enhancement patterns of SHCC in the arterial phase, portal venous phase and delayed phase scanning of MRI and spiral CT were hyper-hypo-hypointense (dense) and hyper-iso- hypointense (dense). Atypical enhancement patterns were hyper-hyper-hyperintense (dense), hyper-iso- isointense (dense) and hypo-hypo-hypointense (dense). Conclusions: Both MRI and spiral CT multi-phase dynamic contrast-enhanced scanning could demon- strate the enhancement features of SHCC, and arte- rial phase scan of MRI was superior to spiral CT in reflecting the hypervascular characterization of SHCC. In addition, MRI was better than spiral CT in characterization of hepatic lesions combined with SE sequence.
文摘Objectives: To evaluate the value of the arterial phase(AP) of biphase enhanced spiral CT(SCT) in the di-agnosis of small HCC and to investigate the criteria,initial time, ending time and duration of AP.Methods: From May 1995 to March 1999, patients withsmall HCC proved surgically and pathologically in-cluding 49 patients (n=53) in group A, 148 (n=186) ingroup B and 52 (n=52) in group C were collected.Biphase dynamic enhanced SCT scans were performedin all patients of the three groups and additional sin-gle-level dynamic scans only done in the group C. Thedetectability, diagnostic accuracy of lesions and en-hancement of the lesions in AP were analyzed statisti-cally. In addition, the initial time, ending time andduration of AP were measured.Results: The results of the group A showed the de-tectability of small HCC was 88.68% in AP and90.57% in both phases, higher than those by ultra-sound. Markedly enhanced lesions in AP accounted for76% and 78% in the groups B and C respectively. Theinitial time, ending time and duration of AP measuredon single-level dynamic scans were 16.9s, 39.6s and22.7s on average respectively.Conclusions: The biphase dynamic SCT especially itsarterial phase appears to be very valuable in diagnosingsmall HCCs. In light of short duration of AP, under-standing and strict control of AP is obviously impera-tive.
