| Accuracy and disagreement of CT and MRI for the diagnosis of small hepatocellular carcinoma and dysplastic nodules: Role of biopsy. | |
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MedLine Citation:
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PMID: 22006503 Owner: NLM Status: Publisher |
Abstract/OtherAbstract:
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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.). |
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Authors:
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Thomas Sersté; Vincent Barrau; Violaine Ozenne; Marie Pierre Vullierme; Pierre Bedossa; Olivier Farges; Dominique-Charles Valla; Valérie Vilgrain; Valérie Paradis; Françoise Degos |
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Publication Detail:
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Type: JOURNAL ARTICLE Date: 2011-10-17 |
Journal Detail:
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Title: Hepatology (Baltimore, Md.) Volume: - ISSN: 1527-3350 ISO Abbreviation: - Publication Date: 2011 Oct |
Date Detail:
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Created Date: 2011-10-18 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 8302946 Medline TA: Hepatology Country: - |
Other Details:
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Languages: ENG Pagination: - Citation Subset: - |
Copyright Information:
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Copyright © 2011 American Association for the Study of Liver Diseases. |
Affiliation:
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Assistance-Publique Hôpitaux de Paris, APHP Service d'Hépatologie, Hôpital Beaujon, Clichy, France; Hepato-Gastroentérologie, Hôpital Saint-Pierre, Université Libre de Bruxelles, Bruxelles, Belgium. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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