Background: Gadolinium-ethoxybenzyl-diethylenetriamine pentaacetic acid (Gd-EOB-DTPA;gadoxetic acid disodium, Primovist, Bayer Healthcare, Berlin, Germany) is a gadolinium based contrast agent with hepatocyte specific...Background: Gadolinium-ethoxybenzyl-diethylenetriamine pentaacetic acid (Gd-EOB-DTPA;gadoxetic acid disodium, Primovist, Bayer Healthcare, Berlin, Germany) is a gadolinium based contrast agent with hepatocyte specific properties. In patients scanned for hepatic metastasis using Gd-EOB-DTPA, it is important to differentiate hepatic metastasis with cysts and hemangiomas, which are the two most common benign lesions seen in the liver. Yet, in some cases it is difficult to differentiate these lesions. Purpose: The purpose of this study was to retrospectively investigate the usefulness of combining Fluid-attenuated inversion recovery (FLAIR) with Gd-EOB-DTPA enhanced MRI. Material and Methods: Gd-EOB-DTPA enhanced MRIs of 47 patients (19 male, 27 female) with a mean age of 68 years (range 32 - 85 years old) with a total of 121 lesions (68 cysts, 37 metastasis, 16 hemangiomas) were included in the study. T1WI, T2WI, heavy T2WI, dynamic contrast enhanced MRI, and FLAIR images of these lesions were evaluated. The patients were randomly divided into two groups (Groups A and B), and two independent radiologists were asked to give a diagnosis for each lesion. The radiologists were allowed to view FLAIR images for only Group B. Diagnostic performance regarding the differentiation of cysts, hemangiomas and metastases was assessed. MRI examinations were scanned using a 1.5 Tesla system (Echlon Vega, Hitachi,) with an 8 channel multiple array coil (RAPID body coil). Results: An statistically significant improvement (p < 0.05) of the specificity for cysts was seen from 71.9% (Group A) to 90.9% (Group B) for Reader 1, and 75.0% (Group A) to 93.3% (Group B) for Reader 2. No statistical differences were seen between the two groups for sensitivity and specificity of hemangiomas. Although no statistical difference was seen between the two groups, an improvement (77.8 in Group A to 97.2 in Group B for Reader 1, and 85.7 in Group A to 100 in Group B for Reader 2) was seen for the sensitivity of metastasis with the addition of FLAIR. Conclusion: An improvement of diagnostic accuracy, especially for cysts, was seen with the addition of FLAIR to Gd-EOB-DTPA enhanced MRI.展开更多
1研究概述2019年Stroke&Vascular Neurology发表的两篇基于M R I不同序列不匹配指导静脉溶栓的研究报道引起了脑血管界的广泛关注[1-2]。两篇文章分别应用了DWI/FLAIR、DWI/PWI和DWI/T2WI不匹配,指导时间窗不明确或者超时间窗的患...1研究概述2019年Stroke&Vascular Neurology发表的两篇基于M R I不同序列不匹配指导静脉溶栓的研究报道引起了脑血管界的广泛关注[1-2]。两篇文章分别应用了DWI/FLAIR、DWI/PWI和DWI/T2WI不匹配,指导时间窗不明确或者超时间窗的患者进行静脉溶栓,得到了安全有效的结果,无疑是令人振奋的。第一项研究在纳入的42例发病时间不明的患者中,进行DWI/PWI不匹配或DWI/FLAIR不匹配,最终发病时间不明组溶栓后3个月预后良好率为76.19%,与4.5 h时间窗内溶栓组的预后良好率70.96%相比,无统计学差异,结果认为在多模式MRI影像指导下.展开更多
文摘Background: Gadolinium-ethoxybenzyl-diethylenetriamine pentaacetic acid (Gd-EOB-DTPA;gadoxetic acid disodium, Primovist, Bayer Healthcare, Berlin, Germany) is a gadolinium based contrast agent with hepatocyte specific properties. In patients scanned for hepatic metastasis using Gd-EOB-DTPA, it is important to differentiate hepatic metastasis with cysts and hemangiomas, which are the two most common benign lesions seen in the liver. Yet, in some cases it is difficult to differentiate these lesions. Purpose: The purpose of this study was to retrospectively investigate the usefulness of combining Fluid-attenuated inversion recovery (FLAIR) with Gd-EOB-DTPA enhanced MRI. Material and Methods: Gd-EOB-DTPA enhanced MRIs of 47 patients (19 male, 27 female) with a mean age of 68 years (range 32 - 85 years old) with a total of 121 lesions (68 cysts, 37 metastasis, 16 hemangiomas) were included in the study. T1WI, T2WI, heavy T2WI, dynamic contrast enhanced MRI, and FLAIR images of these lesions were evaluated. The patients were randomly divided into two groups (Groups A and B), and two independent radiologists were asked to give a diagnosis for each lesion. The radiologists were allowed to view FLAIR images for only Group B. Diagnostic performance regarding the differentiation of cysts, hemangiomas and metastases was assessed. MRI examinations were scanned using a 1.5 Tesla system (Echlon Vega, Hitachi,) with an 8 channel multiple array coil (RAPID body coil). Results: An statistically significant improvement (p < 0.05) of the specificity for cysts was seen from 71.9% (Group A) to 90.9% (Group B) for Reader 1, and 75.0% (Group A) to 93.3% (Group B) for Reader 2. No statistical differences were seen between the two groups for sensitivity and specificity of hemangiomas. Although no statistical difference was seen between the two groups, an improvement (77.8 in Group A to 97.2 in Group B for Reader 1, and 85.7 in Group A to 100 in Group B for Reader 2) was seen for the sensitivity of metastasis with the addition of FLAIR. Conclusion: An improvement of diagnostic accuracy, especially for cysts, was seen with the addition of FLAIR to Gd-EOB-DTPA enhanced MRI.
文摘1研究概述2019年Stroke&Vascular Neurology发表的两篇基于M R I不同序列不匹配指导静脉溶栓的研究报道引起了脑血管界的广泛关注[1-2]。两篇文章分别应用了DWI/FLAIR、DWI/PWI和DWI/T2WI不匹配,指导时间窗不明确或者超时间窗的患者进行静脉溶栓,得到了安全有效的结果,无疑是令人振奋的。第一项研究在纳入的42例发病时间不明的患者中,进行DWI/PWI不匹配或DWI/FLAIR不匹配,最终发病时间不明组溶栓后3个月预后良好率为76.19%,与4.5 h时间窗内溶栓组的预后良好率70.96%相比,无统计学差异,结果认为在多模式MRI影像指导下.
