Document Detail


Hypovascular hypointense nodules on hepatobiliary phase gadoxetic acid-enhanced MR images in patients with cirrhosis: potential of DW imaging in predicting progression to hypervascular HCC.
MedLine Citation:
PMID:  22891358     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE: To investigate the imaging features of hypovascular hypointense nodules on hepatobiliary phase gadoxetic acid-enhanced magnetic resonance (MR) images in patients with cirrhosis that may be associated with progression to hypervascular hepatocellular carcinoma (HCC).
MATERIALS AND METHODS: The institutional review board approved this retrospective study and waived informed patient consent. This study included 135 patients with a diagnosis of hepatitis B-induced liver cirrhosis and 214 hypovascular hypointense nodules on hepatobiliary phase gadoxetic acid-enhanced MR images. MR images were analyzed with respect to nodule size, degree of hypointensity at hepatobiliary phase (four grades), presence of fat, and signal intensity on T1- and T2-weighted and diffusion-weighted (DW) images. Univariate and multivariate Cox regression analyses were used to identify variables that are associated with developing hypervascular HCC.
RESULTS: On follow-up MR images, 139 nodules (65.0%) had no evidence of HCC (mean follow-up, 522 days) (group 1), but 75 (35.0%) became hypervascular HCC (mean follow-up, 388 days) (group 2). Univariable Cox analysis revealed that the degree of hypointensity on hepatobiliary phase images (P=.044 and .001) and hyperintensity on T2-weighted and DW images (P=.001 and .0001) was significantly related to the development of hypervascular HCC. According to the multivariable Cox analysis, no other variable significantly adjusted the model once hyperintensity at initial DW imaging was already included as an associated variable, (hazard ratio, 7.44; 95% confidence interval: 4.28, 12.94; P=.0001).
CONCLUSION: Hyperintensity on DW images in hypovascular hypointense nodules on hepatobiliary phase gadoxetic acid-enhanced MR images in patients with cirrhosis is strongly associated with progression to hypervascular HCC.
Authors:
Young Kon Kim; Won Jae Lee; Min Jung Park; Seong Hyun Kim; Hyunchul Rhim; Dongil Choi
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Publication Detail:
Type:  Journal Article     Date:  2012-08-13
Journal Detail:
Title:  Radiology     Volume:  265     ISSN:  1527-1315     ISO Abbreviation:  Radiology     Publication Date:  2012 Oct 
Date Detail:
Created Date:  2012-09-20     Completed Date:  2012-12-03     Revised Date:  2013-05-02    
Medline Journal Info:
Nlm Unique ID:  0401260     Medline TA:  Radiology     Country:  United States    
Other Details:
Languages:  eng     Pagination:  104-14     Citation Subset:  AIM; IM    
Copyright Information:
© RSNA, 2012.
Affiliation:
Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50 Ilwon-dong, Gangnam-gu, Seoul 135-710, Republic of Korea.
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MeSH Terms
Descriptor/Qualifier:
Aged
Artifacts
Biopsy
Carcinoma, Hepatocellular / diagnosis*
Chi-Square Distribution
Diffusion Magnetic Resonance Imaging / methods*
Disease Progression
Female
Gadolinium DTPA / diagnostic use
Hepatitis B / complications*
Humans
Liver Cirrhosis / virology*
Liver Neoplasms / diagnosis*
Male
Middle Aged
Neovascularization, Pathologic / diagnosis*
Proportional Hazards Models
Retrospective Studies
Statistics, Nonparametric
Chemical
Reg. No./Substance:
0/gadolinium ethoxybenzyl DTPA; 80529-93-7/Gadolinium DTPA
Comments/Corrections
Comment In:
Radiology. 2013 Apr;267(1):317-8   [PMID:  23525722 ]
Radiology. 2013 Apr;267(1):318-9

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


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