A comparative study of gadolinium-ethoxybenzyl-diethylenetriamine pentaacetic acid-enhanced magnetic resonance imaging and contrast-enhanced ultrasound in the detection of intrahepatic lesion

Abstract

We evaluated the diagnostic performance of both gadolinium-ethoxybenzyl-diethylenetriamine pentaacetic acid-enhanced magnetic resonance imaging (Gd-EOB-DTPA-MRI) and contrast-enhanced ultrasound (CEUS) for focal liver lesions, especially for the detection of small (<2 cm) intrahepatic lesions. We retrospectively reviewed patients who underwent Gd-EOB-DTPA-MRI and CEUS before liver resection and compared Gd-EOB-DTPA-MRI and CEUS in the detection of focal liver lesions. A total of 216 patients were included, and 309 lesions were found. The sensitivity values of MRI and CEUS for the main lesion were both more than 95%, and the coincidence rates were both more than 80%. Regarding lesions <2 cm, 135 such lesions were detected by MRI, whereas only 85 were detected by CEUS. For lesions <2 cm, the sensitivity, specificity, and coincidence rates of MRI were significantly better than those of CEUS. Among 27 patients, 50 more lesions were detected by MRI than CEUS, 56% (28/50) of which were malignant. For the large lesion, the diagnostic performance is similar between Gd-EOB-DTPA-MRI and CEUS, and the sensitivity and coincidence rates of both methods are high. Gd-EOB-DTPA-MRI is likely to detect small (<2 cm) focal intrahepatic lesions.

Figure 1.

The 2 methods detected the distribution of lesions with different diameters in 216 patients. For lesions <2 cm, MRI detected significantly more lesions than CEUS (P < .001). CEUS = contrast-enhanced ultrasound, MRI = magnetic resonance imaging.

Figure 2.

Two methods identified different numbers of lesions in the same patient. The patient in image A had hemangioma. The patient in image B had hepatocellular carcinoma. For these patients, CEUS detected only 1 lesion, whereas MRI detected 2 lesions. CEUS was performed 2 days before MRI in the patient with hemangioma and 1 day after MRI in the patient with hepatocellular carcinoma. CEUS = contrast-enhanced ultrasound, MRI = magnetic resonance imaging.