Hepatocellular carcinoma(HCC)is the most common primary liver cancer.Imaging is important for establishing a diagnosis of HCC and early diagnosis is imperative as several potentially curative treatments are available ...Hepatocellular carcinoma(HCC)is the most common primary liver cancer.Imaging is important for establishing a diagnosis of HCC and early diagnosis is imperative as several potentially curative treatments are available when HCC is small.Hepatocarcinogenesis occurs in a stepwise manner on a background of chronic liver disease or cirrhosis wherein multiple genes are altered resulting in a range of cirrhosisassociated nodules.This progression is related to increased cellularity,neovascularity and size of the nodule.An understanding of the stepwise progression may aid in early diagnosis.Dynamic and multiphase contrast-enhanced computed tomography and magnetic resonance imaging still form the cornerstone in the diagnosis of HCC.An overview of the current diagnostic standards of HCC in accordance to the more common practicing guidelines and their differences will be reviewed.Ancillary features contribute to diagnostic confidence and has been incorporated into the more recent Liver Imaging Reporting and Data System.The use of hepatocyte-specific contrast agents is increasing and gradually changing the standard of diagnosis of HCC;the most significant benefit being the lack of uptake in the hepatocyte phase in the earlier stages of HCC progression.An outline of supplementary techniques in the imaging of HCC will also be reviewed.展开更多
目的比较三组MRI优化序列在肝细胞性肝癌高风险人群中对小肝癌的筛查能力。材料与方法收集2017年1月至2020年10月于河南省人民医院行全序列钆塞酸二钠增强MRI检查且有病理结果的121例患者图像,从全序列中提取三组优化序列让两位放射科...目的比较三组MRI优化序列在肝细胞性肝癌高风险人群中对小肝癌的筛查能力。材料与方法收集2017年1月至2020年10月于河南省人民医院行全序列钆塞酸二钠增强MRI检查且有病理结果的121例患者图像,从全序列中提取三组优化序列让两位放射科医师独立评估:(1)平扫组,包括T2WI和DWI序列;(2)增强组,包括蒙片和钆塞酸二钠四期增强图像(动脉早期、动脉期、门静脉期、平衡期);(3)肝胆期组,包括T2WI、DWI和20 min T1-HBP序列。根据病理结果将患者分为肝癌阳性或阴性,计算三组优化序列诊断效能。结果三组优化序列扫描和准备时间(min:s)分别为12:52、13:04、14:06。三组优化序列诊断小肝癌的敏感度及相应95%置信区间为0.855(0.750、0.928)、0.913(0.820、0.967)、0.942(0.858、0.984);特异度为0.731(0.590、0.844)、0.904(0.790、0.968)、0.885(0.766、0.956);符合率0.802(0.719、0.869)、0.909(0.843、0.954)、0.917(0.853、0.960)。三组阳性似然比为3.18、9.51、8.19,阴性似然比为0.19、0.09、0.06,约登指数为0.586、0.817、0.827。结论平扫组敏感度较高,为小肝癌筛查提供一定的帮助;增强组和肝胆期组特异度和符合率高,用于筛查小肝癌的诊断效能更好。展开更多
文摘Hepatocellular carcinoma(HCC)is the most common primary liver cancer.Imaging is important for establishing a diagnosis of HCC and early diagnosis is imperative as several potentially curative treatments are available when HCC is small.Hepatocarcinogenesis occurs in a stepwise manner on a background of chronic liver disease or cirrhosis wherein multiple genes are altered resulting in a range of cirrhosisassociated nodules.This progression is related to increased cellularity,neovascularity and size of the nodule.An understanding of the stepwise progression may aid in early diagnosis.Dynamic and multiphase contrast-enhanced computed tomography and magnetic resonance imaging still form the cornerstone in the diagnosis of HCC.An overview of the current diagnostic standards of HCC in accordance to the more common practicing guidelines and their differences will be reviewed.Ancillary features contribute to diagnostic confidence and has been incorporated into the more recent Liver Imaging Reporting and Data System.The use of hepatocyte-specific contrast agents is increasing and gradually changing the standard of diagnosis of HCC;the most significant benefit being the lack of uptake in the hepatocyte phase in the earlier stages of HCC progression.An outline of supplementary techniques in the imaging of HCC will also be reviewed.
文摘目的比较三组MRI优化序列在肝细胞性肝癌高风险人群中对小肝癌的筛查能力。材料与方法收集2017年1月至2020年10月于河南省人民医院行全序列钆塞酸二钠增强MRI检查且有病理结果的121例患者图像,从全序列中提取三组优化序列让两位放射科医师独立评估:(1)平扫组,包括T2WI和DWI序列;(2)增强组,包括蒙片和钆塞酸二钠四期增强图像(动脉早期、动脉期、门静脉期、平衡期);(3)肝胆期组,包括T2WI、DWI和20 min T1-HBP序列。根据病理结果将患者分为肝癌阳性或阴性,计算三组优化序列诊断效能。结果三组优化序列扫描和准备时间(min:s)分别为12:52、13:04、14:06。三组优化序列诊断小肝癌的敏感度及相应95%置信区间为0.855(0.750、0.928)、0.913(0.820、0.967)、0.942(0.858、0.984);特异度为0.731(0.590、0.844)、0.904(0.790、0.968)、0.885(0.766、0.956);符合率0.802(0.719、0.869)、0.909(0.843、0.954)、0.917(0.853、0.960)。三组阳性似然比为3.18、9.51、8.19,阴性似然比为0.19、0.09、0.06,约登指数为0.586、0.817、0.827。结论平扫组敏感度较高,为小肝癌筛查提供一定的帮助;增强组和肝胆期组特异度和符合率高,用于筛查小肝癌的诊断效能更好。
