Performance of Contrast-Enhanced Sonography Versus MRI With a Liver-Specific Contrast Agent for Diagnosis of Hepatocellular Adenoma and Focal Nodular Hyperplasia
| Autor: | Mirelle Bröker, Robert A. de Man, Jan N. M. IJzermans, Marianne de Vries, Roy S. Dwarkasing, Loes M M Braun, Pavel Taimr |
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| Přispěvatelé: | Surgery, Gastroenterology & Hepatology, Radiology & Nuclear Medicine |
| Rok vydání: | 2019 |
| Předmět: |
Adult
Male medicine.medical_specialty Adenoma Adolescent media_common.quotation_subject Sulfur Hexafluoride Contrast Media 030218 nuclear medicine & medical imaging Adenoma Liver Cell Diagnosis Differential 03 medical and health sciences symbols.namesake Young Adult 0302 clinical medicine Meglumine medicine Organometallic Compounds Contrast (vision) Humans Radiology Nuclear Medicine and imaging GADOBENATE DIMEGLUMINE Fisher's exact test media_common Aged Retrospective Studies Ultrasonography business.industry Liver cell Hepatobiliary disease Liver Neoplasms Focal nodular hyperplasia General Medicine Hepatocellular adenoma Middle Aged medicine.disease Magnetic Resonance Imaging Focal Nodular Hyperplasia 030220 oncology & carcinogenesis symbols Female Radiology business |
| Zdroj: | American Journal of Roentgenology, 214(1), 81-89. American Roentgen Ray Society |
| ISSN: | 1546-3141 0361-803X |
| Popis: | OBJECTIVE. The purpose of this article is to compare contrast-enhanced sonography (CEUS) with sulfur hexafluoride with MRI with the liver-specific contrast agent gadobenate dimeglumine in the diagnosis of hepatocellular adenoma (HCA) and focal nodular hyperplasia (FNH) in a cohort of consecutive patients. MATERIALS AND METHODS. Patients referred to a tertiary center for hepatobiliary disease who had suspected HCA or FNH on MRI performed with an extracellular gadolinium-based contrast agent underwent a prospective workup including CEUS and MRI with a liver-specific contrast agent. Diagnosis was definite when the findings of CEUS and MRI with a liver-specific contrast agent were concordant; histopathologic examination (HPE) was performed for cases with discordant findings. Descriptive statistics and the association between categoric variables were presented as numbers and percentages and were assessed using the Fisher exact test. The primary analysis was patient based. Sensitivity, specificity, and AUC and predictive values for the diagnosis of HCA and FNH were calculated separately for CEUS and MRI with a liver-specific contrast agent. RESULTS. A total of 181 patients were selected for the first analysis. Findings from CEUS and MRI with a liver-specific contrast agent were concordant for 132 patients (73%) and discordant for 49 (27%). HPE was performed for 26 of the 49 patients with discordant findings (53%), with findings indeterminate for two of these patients, the findings of MRI with a liver-specific contrast agent correct for 21 of the remaining 24 patients (87.5%), and the findings of CEUS correct for three of these 24 patients (12.5%) (p < 0.05). For further analysis, 156 patients with concordant findings or HPE-proven cases were included. For CEUS, the sensitivity and specificity for the diagnosis of HCA and FNH were 85% and 87%, respectively; the ROC AUC value was 0.856; and the positive predictive value and negative predictive value were 79% and 90%, respectively. For MRI with a liver-specific contrast agent, the sensitivity and specificity were 95% each, the ROC AUC value was 0.949, and the positive predictive value and negative predictive value were 92% and 97%, respectively, for the diagnosis of HCA and FNH. CONCLUSION. The findings of CEUS and MRI with a liver-specific contrast agent showed fair agreement for the diagnosis of HCA and FNH. MRI with a liver-specific contrast agent is diagnostically correct significantly more often than CEUS in cases with discordant findings that are HPE proven. |
| Databáze: | OpenAIRE |
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