| Purpose: To compare the diagnostic performance of Gadoxetic acidEnhanced MRI(Gd-EOB-DTPA),Contrast-Enhanced Computed Tomography(CECT),Contrast-Enhanced Ultrasonography(CEUS)and Ultrasonography(US)for the detection of Liver metastases.Material and Method: A study was carried out from October 2017 to March 2020,60 patients who were diagnosed as liver metastases by the evidences of histopathology,clinical correlation,and follow-up imaging were selected.Lesions detected by EOB-MRI,CECT,CEUS and US were interpreted in wide spectrum.The number,location on liver segment,diameter of the lesions and pattern of enhancement were noted.The inclusion criteria on our study were: 1)Patients who were histo-pathologically confirmed 2)Patients who were clinically confirmed and evidenced by follow-up And Exclusion Criteria were: 1)Patients with diffuse metastases(>10 metastases)2)Patients who had undergone hepatic surgery 3)Patients recently undergone Chemotherapy and Radiofrequency Ablation 4)patients undergone recent hepatic surgery were excluded.Sensitivity and diagnostic accuracy were calculated and compared.Statistical analysis was done by Wilcoxon,and Chi-Square methods by using SPSS.Results: Total 115 lesions were detected by EOB-MRI,which was significantly higher than other modalities,77 lesions by CECT,53 lesions by CEUS,61 lesions by US.Sensitivity of Gadoxetic acid Enhanced MRI,CECT,CEUS and US were 98%,74.4%,80% and 49% respectively.The number of lesions <1cm in diameter identified by EOM-MRI,CECT,CEUS and US was25(17%),10(12%),3(5%)and 4(4.5%)respectively.EOB-MRI detected highest number of lesions which are less than<1.0cm in diameter(P<0.05).MRI has higher significant difference than CECT,CEUS and BUS(P<0.05).Whereas,CECT and CEUS,CEUS and US have no significant difference(P>0.05).According to the Couinaud’S classification of hepatic segment,number of liver lesions recorded were 5,17,7,19,10,21,16,20 in segment S1,S2,S3,S4,S5,S6,S7,S8 respectively.Segment 6 was most commonly involved.Different primary sources of metastases was analyzed and the primary lesions were from different locations,13,13,10,7,4,6,1,2,1 and 3 from Colon,Rectum,Sigmoid colon,Breast,NPC,Gastric cancer,Cholangiocarcinoma,pancreas,Ileum and Esophagus respectively.81% of metastatic lesions were found originating from the digestive system.Enhancement pattern were noted,and peripheral ring like enhancement was most common.Metastatic lesions originating from the digestive tract and associated organs found hypovascular,while metastatic lesions originating from breast found hypervascular in our study.Possible adverse reaction after the contrast media injection was searched and there was no any acute adverse reaction to be reported.Conclusion: The diagnostic accuracy and the sensitivity of EOB-MRI were better than any other available diagnostic techniques to diagnose and detect the hepatic lesions.EOB-MRI significantly performed better than any other diagnostic modalities with sensitivity of(98%)in terms of number and size of lesions.It was better to diagnose micro lesion <1.0cm(P<0.05).EOB-MRI was also better to characterize the metastatic lesions as per the nature of primary origin and giving especial enhancement pattern.It should be the first choice of diagnostic modality for the suspected case of liver metastases. |
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