Gd-EOB-DTPA MRI combined with contrast-enhanced ultrasound in the diagnosis of hepatocellular carcinoma (< 2cm) on the background of liver cirrhosis

Abstract

Abstract: Objective To analyze the clinical value of Gd-EOB-DTPA enhanced magnetic resonance imaging (Gd-EOB-DTPA MRI) combined with contrast-enhanced ultrasound (CEUS) in the diagnosis of < 2 cm hepatocellular carcinoma, so-called small hepatocellular carcinoma (SHCC), on the background of liver cirrhosis. Methods Fifty-two patients (36 males and 16 females) with focal hepatic nodules (< 2 cm) having high risk of HCC with an average age of (58.6 ± 9.0) years from January 2015 to December 2019 were analyzed retrospectively. All patients had undergone Gd-EOB-DTPA MRI and CEUS. Chi-square test was used to compare the data between SHCC and dysplastic nodules (DN); receiver operating characteristic curve (ROC) curve was used to evaluate the diagnostic efficiency of Gd-EOB-DTPA MRI and CEUS. Results There were 70 nodules in 52 patients, 54 nodules diagnosed as SHCC, 16 as DN. SHCC and DN were significantly different in T1 weighted imaging (T1WI), T2 weighted imaging (T2WI), arterial phase hyperenhancement, hepatobiliary phase, diffusion weighted imaging (DWI) of MRI and arterial phase hyperenhancement of CEUS (P<0.05). The area under the ROC curve of CEUS arterial phase hyperenhancement, Gd-EOB-DTPA MRI hepatobiliary phase low signal and DWI high signal for diagnosing SHCC were higher than that of Gd-EOB-DTPA MRI T1WI low signal, T2WI high signal and arterial phase hyperenhancement, respectively (P<0.05). For diagnosing SHCC, arterial phase hyperenhancement of CEUS combined with low signal intensity in hepatobiliary phase and high signal intensity in DWI of Gd-EOB-DTPA MRI had sensitivity of 95.5%, specificity of 96.3% and accuracy of 96.2%. Conclusion Arterial phase hyperenhancement of CEUS combined with low signal intensity in hepatobiliary phase and high signal intensity in DWI of Gd-EOB-DTPA MRI helps to improve the diagnostic efficiency of SHCC on the background of liver cirrhosis.

Key words: Hepatocellular carcinoma, Gd-EOB-DTPA enhanced magnetic resonance imaging, Contrast-enhanced ultrasonography, Receiver operating characteristic curve

CHEN Yu-feng, ZHU Ze-yuan, CHENG Ying, QI Liang. Gd-EOB-DTPA MRI combined with contrast-enhanced ultrasound in the diagnosis of hepatocellular carcinoma (< 2cm) on the background of liver cirrhosis[J]. Chinese Hepatolgy, 2021, 26(3): 273-275.

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