摘要
BACKGROUND In hepatocellular carcinoma(HCC),detection and treatment prior to growth beyond 2 cm are important as a larger tumor size is more frequently associated with microvascular invasion and/or satellites.In the surveillance of very small HCC nodules(≤2 cm in maximum diameter,Barcelona clinical stage 0),we demonstrated that the tumor markers alpha-fetoprotein and PIVKA-Ⅱare not so useful.Therefore,we must survey with imaging modalities.The superiority of magnetic resonance imaging(MRI)over ultrasound(US)to detect HCC was confirmed in many studies.Although enhanced MRI is now performed to accurately diagnose HCC,in conventional clinical practice for HCC surveillance in liver diseases,unenhanced MRI is widely performed throughout the world.While,MRI has made marked improvements in recent years.AIM To make a comparison of unenhanced MRI and US in detecting very small HCC that was examined in the last ten years in patients in whom MRI and US examinations were performed nearly simultaneously.METHODS In 394 patients with very small HCC nodules,those who underwent MRI and US at nearly the same time(on the same day whenever possible or at least within 14 days of one another)at the first diagnosis of HCC were selected.The detection rate of HCC with unenhanced MRI was investigated and compared with that of unenhanced US.RESULTS The sensitivity of unenhanced MRI for detecting very small HCC was 95.1%(97/102,95%confidence interval:90.9-99.3)and that of unenhanced US was 69.6%(71/102,95%confidence interval:60.7-78.5).The sensitivity of unenhanced MRI for detecting very small HCC was significantly higher than that of unenhanced US(P<0.001).Regarding the location of HCC in the liver in patients in whom detection by US was unsuccessful,S7-8 was identified in 51.7%.CONCLUSION Currently,unenhanced MRI is a very useful tool for the surveillance of very small HCC in conventional clinical follow-up practice.
基金
The study was reviewed and approved by the Ethics Committee of Yokohama Municipal Citizen's Hospital Institutional Review Board(Approval No.21-02-01).
作者简介
Corresponding author:Kazuo Tarao,ORCID number:0000-0002-7161-6748,PhD,Chief Doctor,Tarao's Gastroenterological Clinic,Taiyo-building3F,Futamatagawa2-58-6,Asahi-ku,Yokohama 241-0821,Japan.nrg18449@nifty.com;Akito Nozaki,ORCID number:0000-0002-3310-6632;Hirokazu Komatsu,ORCID number:0000-0001-9613-6698;Tatsuji Komatsu,ORCID number:0000-0002-8293-3773;Masataka Taguri,ORCID number:0000-0001-8902-0056;Katsuaki Tanaka,ORCID number:0000-0003-4989-2073;Testuo Yoshida,ORCID number:0000-0002-1665-7512;Hideki Koyasu,ORCID number:0000-0002-3021-032X;Makoto Chuma,ORCID number:0000-0002-0963-9172;Kazushi Numata,ORCID number:0000-0003-4671-4431;Shin Maeda,ORCID number:0000-0002-0246-1594.
