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Detection of focal hepatic masses: STIR MR vs. CT during arterial portography
E K Paulson1, M E Baker, S S Paine
1Department of Radiology, Duke University Medical Center, Durham, North Carolina 27710.
Objective:
Our goal was to compare short tau inversion recovery MRI (STIR) to CT during arterial portography (CTAP) in the detection of hepatic lesions.
Materials And Methods:
Over a 24 month period, 40 patients evaluated for possible hepatic resection underwent T1, T2, and STIR MRI and CTAP. These studies were randomly ordered and interpreted by two independent readers. The total number of lesions and number of lesions within each hepatic segment were analyzed using McNemar's test.
Results:
Readers 1 and 2 detected 95 and 91 lesions by CTAP and 78 and 83 by STIR, respectively, which was not significantly different (p = 0.1, reader 1; p = 0.4, reader 2). For both readers CTAP and STIR MRI detected more lesions than either T2 or T1 MRI (p < 0.01). In the medial segment, readers 1 and 2 detected 18 and 17 lesions by CTAP and 7 and 9 by STIR, respectively (p = 0.01, reader 1; p = 0.035, reader 2).
Conclusion:
Short tau inversion recovery MRI and CTAP are similar in total lesion detection except in the medial segment where lesions were more frequently identified by CTAP than STIR MRI.
Insights
Short tau inversion recovery MRI (STIR) and CT during arterial portography (CTAP) show similar overall hepatic lesion detection. However, CTAP identified more lesions in the medial segment than STIR MRI.
Area of Science:
- Radiology
- Medical Imaging
- Hepatobiliary Imaging
Background:
- Accurate detection of hepatic lesions is crucial for surgical planning.
- Comparing advanced imaging modalities aids in optimizing diagnostic strategies.
Purpose of the Study:
- To evaluate and compare the efficacy of Short Tau Inversion Recovery MRI (STIR) against CT during Arterial Portography (CTAP) in identifying hepatic lesions.
Main Methods:
- A prospective study involving 40 patients undergoing evaluation for hepatic resection.
- Randomized interpretation of T1, T2, STIR MRI, and CTAP by two independent readers.
- Statistical analysis using McNemar's test to compare lesion detection rates.
Main Results:
- Overall lesion detection rates were comparable between STIR MRI and CTAP for both readers.
- Both STIR MRI and CTAP significantly outperformed T1 and T2 MRI in lesion detection (p < 0.01).
- CTAP detected significantly more lesions in the medial hepatic segment compared to STIR MRI (p = 0.01 for reader 1, p = 0.035 for reader 2).
Conclusions:
- STIR MRI and CTAP demonstrate comparable overall performance in detecting hepatic lesions.
- CTAP exhibits superior detection capabilities for lesions located in the medial segment of the liver.
- These findings suggest a potential advantage of CTAP in specific hepatic regions for surgical planning.