Gadoksetik Asit Disodyum (Gd-Eob-Dtpa) Kullanılarak Elde Olunmuş Abdomen Manyetik Rezonans Görüntülemede Karaciğerdeki Fokal Lezyonların Saptanması ve Karakterizasyonu Açısından Yirminci Dakika Hepatosit Spesifik Faz Görüntüleri ile Difüzyon Ağırlıklı Görüntülerin Karşılaştırılması

Abstract

Number, size, location and characterization of focal liver lesions are very important to choose the proper treatment method and to improve therapeutic outcome. The aim of this study is to compare the significance of hepatobiliary phase of gadoxetic acid disodium (Gd-EOB-DTPA) enhanced magnetic resonance imaging (MRI) and diffusion-weighted imaging (DWI) for detection and characterization of focal liver lesions. 127 patients underwent DWI and Gd-EOB-DTPA enhanced MRI to characterize focal liver lesions. Gd-EOB-DTPA enhanced MRI including T(2) weighted sequences, early dynamic T(1) weighted sequences, twenty minutes delayed hepatobiliary phase sequences, and DWI were obtained. Each sequence was evaluated separately from other sequences. Then the most diagnostic sequence for characterization was noted for each lesion. 114 liver metastases, 48 hepatocellular carcinomas (HCC), 75 hemangiomas, 15 focal nodular hyperplasia (FNH), and 28 simple parenchymal liver cysts were detected. Hepatobiliary phase of Gd-EOB-DTPA enhanced MRI yielded equal sensitivity to DWI for detecting metastases (79% at both of them) however hepatobiliary phase MRI yielded significantly higher sensitivity (85.4%) than DWI (64.6%) for detecting HCC. Hepatobiliary phase MRI had higher sensitivity (88.1%) than DWI (83.05%) for detecting benign liver lesions which was statistically insignificant (p>0.05). The most diagnostic sequences were early dynamic T(1) weighted sequences and hepatobiliary phase for HCC, DWI for metastases, hepatobiliary phase for FNH, early dynamic T(1) weighted sequences for hemangioma and T(2) weighted sequences for simple parenchymal cyst. Hepatobiliary phase of Gd-EOB-DTPA enhanced MRI had the highest sensitivity for detecting HCC among all other sequences however it didn't have a significant role for detecting other benign or malignant lesions.