Comparison of DWI with short tau inversion recovery sequence and chemical shift selective sequence in gadolinium ethoxybenzyl diethylenetriaminepentaacetic acid enchanced MR for detecting hepatocellular carcinoma / 中国医学影像技术

ABSTRACT

Objective: To compare the detectability of hepatocellular carcinoma (HCC) based on DWI during gadolinium ethoxybenzyl diethylenetriaminepentaacetic acid (Gd-EOB-DTPA) enhanced MR scanning between short tau inversion recover (STIR) and chemical shift selective (CHESS) sequences. Methods: Thirty-seven patients with pathologically confirmed HCC were selected for retrospective analysis. All patients underwent Gd-EOB-DTPA enhanced MR scanning of the upper abdomen. Images of DWIs with STIR and CHESS sequences were acquired at 13-15 minutes after Gd-EOB-DTPA injection. The signal intensity (SI), standard deviation (SD), ADC of liver parenchyma and SI,ADC of HCC on DWI with STIR and CHESS sequences were measured. And the SNR of liver parenchyma and CNR of HCC were calculated. The visual grade of conspicuity of HCC and the clarity of hepatic anatomical structure were scored on both two sequences. Statistical analysis was performed. SNR of liver parenchyma, CNR of HCC, ADC of liver parenchyma and HCC, as well as visual score of HCC conspicuity, clarity of hepatic anatomical structure were compared between DWI with STIR and CHESS sequences. The consistency of observation scores between two physicians were also analyzed. Results: CNR of HCC of STIR sequence was significantly higher than that of CHESS sequence (P=0.034). SNR of liver parenchyma, as well as ADC of liver parenchyma and HCC of STIR sequence were significantly lower than those of CHESS sequence (all P<0.05). The consistency of visual scores of HCC conspicuity and clarity of hepatic anatomical structure between the two physicians were good (both Kappa≥0.75). Visual scores of physician-1 and physician-2 of HCC conspicuity and the clarity of hepatic anatomical structure were significantly different between STIR and CHESS sequences (all P<0.001). Most of the visual scores of HCC conspicuity of STIR sequence were scored as 4, and most of the clarity of hepatic anatomical structure scores were as 1. The visual scores of HCC conspicuity and clarity of hepatic anatomical structure of CHESS sequence were mainly scored as 3. Conclusion: DWI using STIR sequence is helpful to detecting HCC after Gd-EOB-DTPA administration compared with CHESS sequence.