Publication: Sirozlu hastalarda karaciğer lezyonlarının değerlendirilmesinde dinamik çıkarmalı manyetik rezonans görüntülemenin rolü The role of magnetıc resonance
Abstract
Giriş: Bu çalışmanın amacı siroz hastalarında karaciğerde lezyon belirleme ve değerlendirme aşamasında dinamik çıkarmalı manyetik rezonans (MR) görüntülemenin rolünün araştırılmasıdır. Gereç ve Yöntem: Sirozlu 30 hastaya karaciğerde lezyon varlığını araştırmak için standart karaciğer MR protokolü ile inceleme yapılmıştır. Daha sonra dinamik görüntülere çıkarma işlemi uygulanmıştır. Standart protokol ve tek başına çıkarma yöntemi ile elde edilen görüntüler lezyon bazında analiz edilerek; duyarlılık, özgüllük, pozitif ve negatif tahmin değerleri araştırılmıştır. Bulgular: Hastaların yaş aralığı 45-86, yaş ortalaması 65.6 olup median değeri 64.5 idi. Standart protokol ve çıkarma görüntülerinde 14 hastada lezyon saptanmamıştır. 16 hastada standart protokol görüntülerinde 20, tek başına dinamik çıkarmalı görüntülerde 21 lezyon saptanmıştır. Lezyon bazında standart protokole göre çıkarmalı (subtraction) görüntülemenin lezyon belirlemede duyarlılığı %95.5, özgüllüğü %87.5, pozitif tahmin değeri %90.5, negatif tahmin değeri %93.3, doğruluğu %91.6 olarak bulunmuştur. Sonuç: Karaciğerde lezyon sayılarının görsel olarak değerlendirilmesinde çıkarmalı görüntüleme tek başına standart protokole üstün değildir. Ancak standart protokole çıkarma görüntülerinin eklenmesi sirotik karaciğerdeki lezyonların değerlendirilmesinde tanısal etkinliği arttırmaktadır.
Introduction: The aim of this study is to evaluate the role of the Magnetic Resonance Imaging (MRI) with Dynamic Subtraction in determining liver lesions with cirrhosis. Materials and Method: We investigated the presence of lesions in the liver with standard MRI protocol among 30 patients with cirrhosis. Subsequently, subtraction process was applied to the dynamic images. Images obtained with standard and subtraction methods were analyzed; and the sensitivity, specificity, positive and negative predictive values were investigated. Results: The age range was 45-86, the average age was 65.6 and the median age was 64.5 years. On standard and subtraction images, no lesion was found in 14 patients. In 16 patients, after evaluation with standard protocol, 20 lesions were found. On dynamic images, 21 lesions were identified. When compared to standard protocol, with dynamic subtraction imaging, sensitivity to detect a lesion was found as 95.5%, whereas specificity was 87.5%, positive predictive value was 90.5%, negative predictive value was 93.3% and the accuracy was 91.6%. Conclusion: In the identification of the number of liver lesions, subtraction imaging was not superior to the standard protocole alone. However, the addition of subtraction images on the standard protocol improves the evaluation quality for lesions detected in cirrhotic liver.
Introduction: The aim of this study is to evaluate the role of the Magnetic Resonance Imaging (MRI) with Dynamic Subtraction in determining liver lesions with cirrhosis. Materials and Method: We investigated the presence of lesions in the liver with standard MRI protocol among 30 patients with cirrhosis. Subsequently, subtraction process was applied to the dynamic images. Images obtained with standard and subtraction methods were analyzed; and the sensitivity, specificity, positive and negative predictive values were investigated. Results: The age range was 45-86, the average age was 65.6 and the median age was 64.5 years. On standard and subtraction images, no lesion was found in 14 patients. In 16 patients, after evaluation with standard protocol, 20 lesions were found. On dynamic images, 21 lesions were identified. When compared to standard protocol, with dynamic subtraction imaging, sensitivity to detect a lesion was found as 95.5%, whereas specificity was 87.5%, positive predictive value was 90.5%, negative predictive value was 93.3% and the accuracy was 91.6%. Conclusion: In the identification of the number of liver lesions, subtraction imaging was not superior to the standard protocole alone. However, the addition of subtraction images on the standard protocol improves the evaluation quality for lesions detected in cirrhotic liver.