Document Detail


Accuracy and disagreement of CT and MRI for the diagnosis of small hepatocellular carcinoma and dysplastic nodules: Role of biopsy.
MedLine Citation:
PMID:  22006503     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
Liver macronodules ranging from benign to low grade or high grade dysplastic nodules (LGD/HGDN) and hepatocellular carcinoma (HCC) may develop during chronic liver diseases (CLD). Current guidelines were recently updated and the non-invasive criteria for the diagnosis of small HCC are based on a single typical radiological pattern, and not conclusive coincidental findings with two techniques. This study aimed to assess the accuracy and disagreements of non-invasive multiphasic examinations for the diagnosis of HCC and DN and role of biopsy. Seventy-four consecutive patients with CLD with ultrasound-detected 1-2 cm nodule underwent within 1 month, multiphasic CT, MRI and biopsy of the nodule. Median age was 60 years, 33 patients (45%) had hepatitis C virus, 20 (27%) Hepatitis B virus, 13 (18%) patients no cirrhosis. Biopsy revealed 47 HCC, 6 HGDN, 1LGDN, 1 cholangiocarcinoma and 1 epithelioid hemangioendothelioma. There was no tumor in the other 18 patients. All patients (31/31, 100%) who had conclusive coincidental findings (arterial enhancement and washout) on both examinations had HCC or HGDN (sensitivity 57%, specificity 100%). All patients (51/51, 100%) who had conclusive findings on at least one of the two examinations had HCC or HGDN (sensitivity 96%, specificity 100%). There was a disagreement regarding imaging findings between CT and MRI in 21/74 (28%) patients and no washout on both examinations in 23/74 patients (31%). In these 44 patients, liver biopsy provided an initial accurate diagnosis. Conclusion: The non-invasive diagnosis of HCC or HGDN can be obtained if arterial enhancement and washout are found in a single dynamic imaging examination. These findings are frequently discordant on both CT and MRI, supporting the place of biopsy for diagnosis of small HCCs. (HEPATOLOGY 2011.).
Authors:
Thomas Sersté; Vincent Barrau; Violaine Ozenne; Marie Pierre Vullierme; Pierre Bedossa; Olivier Farges; Dominique-Charles Valla; Valérie Vilgrain; Valérie Paradis; Françoise Degos
Related Documents :
9629403 - Comparison of mri-guided and ventriculography-based stereotactic surgery for parkinson'...
21748653 - Diagnostic significance of magnetic resonance imaging in preoperative evaluation of pat...
7489303 - Magnetic resonance imaging of the knee. a senior musculoskeletal radiologist's perspect...
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-10-17
Journal Detail:
Title:  Hepatology (Baltimore, Md.)     Volume:  -     ISSN:  1527-3350     ISO Abbreviation:  -     Publication Date:  2011 Oct 
Date Detail:
Created Date:  2011-10-18     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8302946     Medline TA:  Hepatology     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2011 American Association for the Study of Liver Diseases.
Affiliation:
Assistance-Publique Hôpitaux de Paris, APHP Service d'Hépatologie, Hôpital Beaujon, Clichy, France; Hepato-Gastroentérologie, Hôpital Saint-Pierre, Université Libre de Bruxelles, Bruxelles, Belgium.
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Descriptor/Qualifier:

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


Previous Document:  Topical silver sulfadiazine for the prevention of acute dermatitis during irradiation for breast can...
Next Document:  Fragmentation without extraction in ureteral stones: outcomes of 238 cases.