Diagnosing and Staging of Cystic Echinococcosis How Do CT and MRI Perform in Comparison to Ultrasound 英文参考文献.docVIP

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Diagnosing and Staging of Cystic Echinococcosis How Do CT and MRI Perform in Comparison to Ultrasound 英文参考文献.doc

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Diagnosing and Staging of Cystic Echinococcosis How Do CT and MRI Perform in Comparison to Ultrasound 英文参考文献

DiagnosingandStagingofCysticEchinococcosis:How DoCTandMRIPerforminComparisontoUltrasound? MarijaStojkovic1,KerstinRosenberger1,Hans-UllrichKauczor2,ThomasJunghanss1*,WaldemarHosch2 1Section Clinical Tropical Medicine, Department of Infectious Diseases, Heidelberg University Hospital, Heidelberg, Germany, 2Department of Diagnostic and InterventionalRadiology,HeidelbergUniversityHospital,Heidelberg,Germany Abstract Background:ImagingplaysthekeyroleindiagnosingandstagingofCE.ThedescriptionofCE-specificimagingfeatures andtheWHOCEcystclassificationisbasedonultrasound.Thereproducibilityoftheultrasound-definedfeaturesofCEcysts isvariableinMR-andCT-imaging.ThisisofparticularimportanceforcyststhatarenotaccessiblebyUSandbecauseofthe increasingavailabilityandoveruseofCTandMRimaging. Methodology/PrincipalFindings:RetrospectiveanalysisofpatientswithabdominalCEcystsofaninterdisciplinaryCEclinic whohadCTand/orMRIscansperformedadditionallytoUSimaging.Allimageswerereadandinterpretedbythesame senior radiologist experienced in the diagnosis of CE. US, CT and MR images were staged according to the WHO classificationcriteria.Theagreementbeyondchancewasquantifiedbykappacoefficients(k).107patientswith187CEcysts mettheinclusioncriteria.AllcystswereassessedbyUS,138byCT,and125byMRI.Thelevelofagreementbeyondchance oftheindividualCEstages1–4wasclearlylowerforCT,withkrangingfrom0.62to0.72,comparedtoMRIwithvaluesofk between0.83and1.0.ForCE5cystsCT(k=0.95)performedbetterthanMRI(k =0.65). Conclusions: Ultrasound remains the corner stone of diagnosis, staging and follow up of CE cysts. MRI reproduces the ultrasound-definedfeaturesofCEbetterthanCT.IfUScannotbeperformedduetocystlocationorpatient-specificreasons MRIwithheavilyT2-weightedseriesispreferabletoCT. Citation:StojkovicM,RosenbergerK,KauczorH-U,JunghanssT,HoschW(2012)DiagnosingandStagingofCysticEchinococcosis:HowDoCTandMRIPerform inComparisontoUltrasound?PLoSNeglTropDis6(10):e1880.doi:10.1371/journal.pntd.0001880 Editor:HectorH.Garcia,Unive