Application of MRI Dual Lava early and late arterial phases combined with portal phase contrast-enhanced scanning in the diagnosis of liver cancer

Abstract

Abstract: Objective To investigate the value of magnetic resonance imaging (MRI) Dual liver volume rapid three-dimensional imaging (Lava) early and late arterial phases combined with portal phase contrast-enhanced scanning in the diagnosis of liver cancer. Methods The clinical data of 393 patients with liver space-occupying lesions who underwent MRI examination in the hospital from January 2021 to December 2021 were retrospectively analyzed. Pathological examination results were recorded. The MRI imaging findings were compared with the pathological findings. The imaging features of MRI imaging in patients with liver disease were observed. The diagnostic value of MRI Dual Lava arterial early and late arterial phases combined with portal phase contrast-enhanced scanning technology for liver cancer was analyzed by Receiver operating characteristic curve (ROC) method. Results Among the 393 lesions, 55 lesions were diagnosed as liver cancer by pathological examination, and the detection rate was 13.99%. A total of 358 lesions were detected by MRI Lava early and late arterial phases combined with portal venous phase contrast-enhanced scanning, with a detection rate of 91.09%, including 46 liver cancers and 312 benign liver lesions. Dual Lava showed marked enhancement in arterial phase, decreased signal in portal venous phase and delayed phase, and "pseudocapsule" signs were seen. The positive detection rate of Dual Lava arterial phase in MRI scan results of liver cancer patients was higher than those of T1W1, T2W1, delayed phase, and protal venous phase (=4.398, 8.731, 7.566, 11.210, P=0.036, 0.003, 0.006, 0.001). The sensitivity of MRI Dual Lava technology for diagnosing liver cancer was 83.63% (95%CI: 70.69%~91.79%), the specificity was 92.30% (95%CI: 88.80%~94.82%), and the accuracy was 91.09% (95%CI: 87.72%~93.64%), the area under the curve (AUC) was 0.850 (95%CI: 0.842~0.915). Conclusion MRI Dual Lava arterial early and late phases combined with portal venous phase contrast-enhanced scanning has high diagnostic value for liver cancer.

Key words: Liver cancer, Diagnosis, Magnetic resonance imaging, Rapid three-dimensional imaging of liver volume, Arterial phase, Portal venous phase

YANG Li-yue, YANG Xiao-liang, YIN Hui-kang. Application of MRI Dual Lava early and late arterial phases combined with portal phase contrast-enhanced scanning in the diagnosis of liver cancer[J]. Chinese Hepatolgy, 2023, 28(6): 673-675.

References

[1] Alenezi A O, Krishna S, Mendiratta-Lala M, et al. Imaging and management of liver cancer. Semin Ultrasound CT MR, 2020, 41(2):122-138.
[2] Welle CL, Venkatesh SK, Reeder SB, et al. Dual contrast liver MRI: a pictorial illustration. Abdom Radiol (NY), 2021, 46(10):4588-4600.
[3] 王晶晶, 邰兆琴, 吴鹤林, 等. MRI增强扫描在肝癌诊断及疗效评估中的应用观察. 中国CT和MRI杂志, 2021, 19(12):93-95.
[4] Carbonell G, Taouli B. Abbreviated MRI protocols for chronic liver disease and liver cancer. Magn Reson Imaging Clin N Am, 2021, 29(3):321-327.
[5] 宋磊. 钆贝葡胺核磁共振增强与CT多期增强扫描对肝硬化伴小肝癌诊断的对比研究. 中西医结合肝病杂志, 2021, 31(5):449-451.
[6] Subramanian M, Low HM, Kim MJ, et al. Benign focal liver lesions masquerading as primary liver cancers on MRI. Diagn Interv Radiol, 2020, 26(3):168-175.
[7] 侯键. 医学影像学. 北京: 中国中医药出版社, 2013:43-45.
[8] 石木兰. 肿瘤影像学(精). 北京: 科学出版社, 2006:28-31.
[9] 孙青, 张成琪. 肿瘤影像学与病理学诊断. 北京: 人民军医出版社, 2013: 334-336.
[10] 高德军, 陈耀康, 罗鹰, 等. 3.0 T MR-LAVA序列多期动态增强扫描对肝硬化结节病变定性诊断的临床价值研究. 实用肝脏病杂志, 2019, 22(3):393-396.
[11] Wang DC, Jang HJ, Kim TK. Characterization of indeterminate liver lesions on CT and MRI with contrast-enhanced ultrasound: what is the evidence. AJR Am J Roentgenol, 2020, 214(6):1295-1304.
[12] Guniganti P, Kierans AS. PET/MRI of the hepatobiliary system: review of techniques and applications. Clin Imaging, 2021, 71(46):160-169.
[13] Cunha GM, Sirlin CB, Fowler KJ. Imaging diagnosis of hepatocellular carcinoma: LI-RADS. Chin Clin Oncol, 2021, 10(1):3-6.
[14] 周围, 柏根基, 单文莉, 等. 普美显MRI增强检查对肝细胞肝癌定性诊断的价值. 实用放射学杂志, 2019, 35(7):1073-1076.
[15] 贾易璇, 杨胜男, 杨剑. 肝脏MRI与增强CT诊断原发性肝癌的价值比较. 黑龙江医药科学, 2021, 44(5):186-187+190.
[16] Kanmaniraja D, Dellacerra G, Holder J, et al. Liver imaging reporting and data system (LI-RADS) 2018: review of the CT/MRI diagnostic categories. Can Assoc Radiol J, 2021, 72(1):142-149.
[17] 黄斌, 马永刚, 陈利军, 等. 3.0TMR LAVA增强扫描在胰头癌和肿块型胰腺炎的鉴别诊断价值. 医学影像学杂志, 2019, 28(10): 1687-1690.
[18] Cunha GM, Tamayo-Murillo DE, Fowler KJ. LI-RADS and transplantation: challenges and controversies. Abdom Radiol (NY), 2021, 46(1):29-42.
[19] An JY, Pena MA, Cunha GM, et al. Abbreviated MRI for hepatocellular carcinoma screening and surveillance. Radiographics, 2020, 40(7):1916-1931.
[20] 田洪斌. 核磁共振3D-LAVA动态增强技术对小肝癌的诊断价值. 影像研究与医学应用, 2019, 3(20):46-51.
[21] Kang JH, Choi SH, Lee JS, et al. Interreader agreement of liver imaging reporting and data system on mri: a systematic review and meta-analysis. J Magn Reson Imaging, 2020, 52(3):795-804.
[22] Zech CJ, Ba-Ssalamah A, Berg T, et al. Consensus report from the 8th international forum for liver magnetic resonance imaging. Eur Radiol, 2020, 30(1):370-382.