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Feasibility of Quadruple Arterial Phase of Motion Insensitive Radial Volumetric Imaging Breath-Hold Examination with k-Space Weighted Image Contrast in the Detection of Hepatocellular Carcinoma in Patients with Chronic Liver Disease

만성 간질환 환자의 간세포암의 발견에 있어 움직임에 덜 민감한 k 공간강조영상대조도의 호흡정지 Radial 체적 영상을 이용한 사중 동맥기 간 자기공명영상의 시행 가능성 분석

  • Lee, Min Ah (Department of Radiology, Jeju National University Hospital, Jeju National University School of Medicine) ;
  • Kim, Bong Soo (Department of Radiology, Jeju National University Hospital, Jeju National University School of Medicine) ;
  • Lee, Jeong Sub (Department of Radiology, Jeju National University Hospital, Jeju National University School of Medicine) ;
  • Kim, Seung Hyoung (Department of Radiology, Jeju National University Hospital, Jeju National University School of Medicine) ;
  • Choi, Guk Myung (Department of Radiology, Jeju National University Hospital, Jeju National University School of Medicine) ;
  • Lee, Ho Kyu (Department of Radiology, Jeju National University Hospital, Jeju National University School of Medicine) ;
  • Lee, Kyung Ryeol (Department of Radiology, Jeju National University Hospital, Jeju National University School of Medicine)
  • 이민아 (제주대학교 의학전문대학원 제주대학교병원 영상의학과) ;
  • 김봉수 (제주대학교 의학전문대학원 제주대학교병원 영상의학과) ;
  • 이정섭 (제주대학교 의학전문대학원 제주대학교병원 영상의학과) ;
  • 김승형 (제주대학교 의학전문대학원 제주대학교병원 영상의학과) ;
  • 최국명 (제주대학교 의학전문대학원 제주대학교병원 영상의학과) ;
  • 이호규 (제주대학교 의학전문대학원 제주대학교병원 영상의학과) ;
  • 이경렬 (제주대학교 의학전문대학원 제주대학교병원 영상의학과)
  • Received : 2018.03.16
  • Accepted : 2018.06.14
  • Published : 2018.10.01

Abstract

Purpose: To evaluate the detection performance of hepatocellular carcinoma and image quality in patients with chronic liver disease with quadruple arterial MR imaging using radial volumetric imaging breath-hold examination (VIBE) with k-space weighted image contrast (KWIC). Materials and Methods: Forty-four patients underwent liver MR examinations with quadruple arterial imaging using radial VIBE-KWIC sequence (full-frame and four sub-frame images). Diagnostic performance was evaluated with receiver operating characteristics (ROC) for detection of hepatocellular carcinoma. The image quality and severity of artifact were scored by using the five-point scale. Results: The area under the ROC curve (Az) value of Hepatocelluar Carcinoma (HCC) detectability was the highest on third sub-frame images, followed by full-frame images. The Az values of third sub-frame and full-frame about the detection of HCC were statistically significantly different from the Az value of first sub-frame images. The full-frame and four sub-frame images showed acceptable image quality and low degree artifact with rating of higher than grade 3. Conclusion: Quadruple arterial MRI using radial VIBE-KWIC is a feasible method for detecting hepatocellular carcinoma in patients with chronic liver disease without deterioration of image quality. The third sub-frame and full-frame image are superior to other sub-frame images in detecting hepatocellular carcinoma.

목적: 만성 간질환 환자에서 radial volumetric imaging breath-hold examination (이하 VIBE) with k-space weighted image contrast (이하 KWIC) 방법을 이용한 사중 동맥기 간 자기공명 영상의 간세포암 발견능과 영상의 질을 평가하고자 한다. 대상과 방법: 총 44명의 환자를 대상으로 radial VIBE-KWIC 사중 조영 증강 동맥기 간 자기공명영상을 시행하였다. 간세포암의 진단능은 receiver operating characteristics (이하 ROC)를, 전반적 영상의 질과 인공물의 정도는 5점 척도를 사용하여 평가하였다. 결과: ROC curve의 아래면적 값은 세 번째 sub-frame에서 가장 큰 값을, full-frame에서 두 번째로 큰 값을 보였으며 첫번째 sub-frame과 비교하여 통계적으로 유의하게 높았다. 전반적 영상의 질 및 인공물의 정도는 모든 영상에서 진단할 만한 정도의 영상을 얻을 수 있었고 full-frame에서 가장 높은 점수를 보였다. 결론: Radial VIBE-KWIC을 이용한 사중 동맥기 간 자기공명영상은 영상의 질의 저하 없이 간세포암을 발견하는데 있어서 유용하며, 세 번째 sub-frame과 full-frame이 다른 sub-frame에 비하여 더 우월하다.

Keywords

Acknowledgement

Supported by : 지멘스 헬시니어스

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