부피여기 열쇠구명기법의 4차원 T1 강조영상 고화질영상을 이용한 동맥기 삼중시기 간 자기공명영상 : 국소 간 병변에 대한 초기 임상 경험과 시행가능성 분석
Triple arterial phase hepatic MRI using four dimensional T1-weighted high resolution imaging with volume excitation keyhole technique : Feasibility and initial clinical experience in focal liver lesions
- 주제(키워드) 4D THRIVE
- 발행기관 고려대학교 대학원
- 지도교수 김윤환
- 발행년도 2012
- 학위수여년월 2012. 8
- 학위구분 석사
- 학과 일반대학원 의학과
- 세부전공 영상의학과학
- 원문페이지 32 p
- 실제URI http://www.dcollection.net/handler/korea/000000034989
- 본문언어 한국어
- 제출원본 000045715950
초록/요약
Purpose: To prospectively investigate a new image acquisition method (4D THRIVE) for that enables an accurate hepatic arterial phase definition in high temporal and spatial resolution. Feasibility and its potential for characterizing focal liver lesions (FLLs) are evaluated. Material and Methods: Thirty-eight patients with 115 FLLs underwent liver MRI that included the 4D THRIVE-CENTRA-keyhole sequence. Triple arterial phase was obtained during a single breath-hold. Images were reviewed for image quality, lesion conspicuity, and lesion detection per each arterial phase and through all three phases. Two radiologists independently assessed MR images and were blinded to all clinical information. The images from the early, middle, late and through triple arterial phase were reviewed separately and in random order. The image quality was scored using five-point scale and one phase for lesion with greatest conspicuity was selected. The enhancement pattern for FLLs was analyzed. Reference standard comprised of histopathology, other concurrent imaging, or follow-up imaging. The interobserver agreement between two radiologists for image quality was examined by using ĸ statistic. Results: The detection rates of each reviewers were 38(33%) and 58 (50%) for early phase, 56(49%) and 70 (61%) for middle, 71 (61%) and 82 (61%) for late, and equally 71 (61%) for whole triple arterial phase, respectively. The image quality was greater than grade 3 for both observers and fair interobserver agreement (ĸ value; 0.45). The late arterial phase showed greater conspicuity (68% for observer A and 61% for observer B) with statistical significance (p<.05). Hepatocellular carcinomas (n=38) enhancement pattern included: homogenous (n=19), heterogeneous (n=9), rim enhancement (n=7), nodule-in-nodule pattern (n=1) and no enhancement (n=2), respectively. Metastasis (n=14) showed rim enhancement (n=6), homogenous (n=3) and no enhancement (n=5). Most hemangiomas (75%) demonstrated homogenous (n=6) rather than centripetal enhancement (n=3). Conclusion: High-resolution triple arterial phase using 4D THRIVE-CENTRA-keyhole technique shows the potential of arterial enhancement and provides additional information for liver lesion characterization.
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