RESUMO
OBJECTIVES: To evaluate the feasibility and diagnostic value of using a 2D spin-echo MR elastography (SE-MRE) sequence at 3.0 Tesla for solid focal liver lesions (FLL) characterization. METHODS: This prospective study included 55 patients with solid FLL (size > 20 mm), who underwent liver SE-MRE at 3 Tesla between 2016 and 2019. Stiffness measurements were performed by two independent readers blinded to the complete MRI exam or patient information. Histological confirmation or typical behavior on the complete MRI exam evaluated in consensus by expert abdominal radiologists was used as reference standard. FLLs were grouped and compared (malignant vs. benign) using the Mann-Whitney and Kruskal-Wallis tests. MRE diagnostic performance was assessed, and stiffness cutoffs were obtained by analysis of ROC curves from accuracy maximization. A linear regression plot was used to evaluate inter-rater agreement for FLLs stiffness measurements. p values < 0.05 were considered statistically significant. RESULTS: The final study group comprised 57 FLLs (34 malignant, 23 benign). Stiffness measurements were technically successful in 91.23% of lesions. To both readers, the median stiffness of the lesions categorized as benign was 4.5 ± 1.5 kPa and in the malignant group 6.8 ± 1.7 and 7.5 ± 1.5 kPa depending on the reader. A cutoff of 5.8 kPa distinguished malignant and benign lesions with 88% specificity and 75-85% accuracy depending on the reader. The inter-rater agreement was 0.90 ± 0.04 with a correlation coefficient of 0.94. CONCLUSION: 2D-SE-MRE at 3.0 T provides high specificity and PPV to differentiate benign from malignant liver lesions. Trial registration 18FFUA-A02.
Assuntos
Técnicas de Imagem por Elasticidade , Neoplasias Hepáticas , Humanos , Fígado/diagnóstico por imagem , Neoplasias Hepáticas/diagnóstico por imagem , Imageamento por Ressonância Magnética , Estudos Prospectivos , Reprodutibilidade dos TestesRESUMO
Se presenta el caso de un varón de 44 años de edad, que consultó por fiebre de origen desconocido de dos semanas de evolución. Los cultivos revelaron la presencia del microorganismo Brucella Canis.
Assuntos
Humanos , Masculino , Adulto , Brucelose/diagnóstico por imagem , Espectroscopia de Ressonância Magnética , Tomografia Computadorizada por Raios X , Doenças Endêmicas , Brucella canisRESUMO
La fibrosis es un destino donde convergen variados trastornos hepáticos. Al tratarse de un proceso dinámico y reversible, su detección temprana y una intervención terapéutica oportuna, pueden frenar su progresión. La elastografía por resonancia magnética (ERM), es un método no invasivo con notable eficacia para la valoración del grado de fibrosis hepática. La tendencia actual es combinar esa técnica con secuencias de cuantificación de lípidos y hierro, lo cual permite un abordaje multiparamétrico de los trastornos difusos del hígado.
Fibrosis is a common destination where multiple liver disorders converge. Due to its dynamic and reversible process, an early detection and timely therapeutic intervention can interrupt its progression. Magnetic Resonance Elastography (MRE) is a non-invasive method with remarkable efficacy for assessing the degree of liver fibrosis. The current trend is to combine this technique with lipid and iron quantification sequences, which allows a multiparametric approach to diffuse liver disorders.
