CT Evaluation of the Progression of Hypoattenuating Nodular Lesions in Virus-Related Chronic Liver Disease
| Autor: | Michiie Sakamoto, Kazuaki Shimada, Tadatoshi Takayama, Kenichi Takayasu, Yukio Muramatsu, Yasunori Mizuguchi, Takuji Okusaka |
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| Rok vydání: | 2006 |
| Předmět: |
Male
medicine.medical_specialty Carcinoma Hepatocellular Chronic liver disease Lesion Liver disease Hepatitis B Chronic medicine Carcinoma Humans Radiology Nuclear Medicine and imaging Aged Retrospective Studies Hypoattenuation business.industry Liver Neoplasms Retrospective cohort study General Medicine Hepatitis C Hepatitis C Chronic Middle Aged medicine.disease medicine.anatomical_structure Disease Progression Female Radiology medicine.symptom Tomography X-Ray Computed business Artery |
| Zdroj: | American Journal of Roentgenology. 187:454-463 |
| ISSN: | 1546-3141 0361-803X |
| Popis: | The purpose of this study was to clarify the natural outcomes of hypoattenuating nodular lesions in patients with virus-related chronic liver disease depicted on dynamic CT.Sixty lesions (mean size, 1.3 cm) exhibiting hypoattenuation or isoattenuation in the arterial and delayed phases of dynamic CT were retrospectively evaluated with additional CT (mean, six examinations) for a mean period of 838 days. The primary end point was emergence of hyperattenuating areas within hypoattenuating lesions, a phenomenon called attenuation conversion. Cumulative attenuation conversion rates suggesting rates of malignant transformation were calculated with the Kaplan-Meier method, and factors affecting attenuation conversion rate were analyzed with the Cox proportional hazard model.Thirty-six (60%) of 60 hypoattenuating lesions developed to hyperattenuating lesions, 21 were unchanged, and three disappeared spontaneously. The 36 lesions that became hyperattenuating were divided into two subgroups according to lesion enhancement pattern: hyper-in-hypoattenuating (n = 25) and entirely hyperattenuating (n = 11). The cumulative attenuation conversion rates for the 60 hypoattenuating lesions were 15.8%, 44.3%, and 58.7% at 1, 2, and 3 years. The hyper-in-hypoattenuating lesions showed more rapid progression to entirely enhanced lesions. Positive results for hepatitis C viral antibody (p = 0.028) and initial lesion size (p = 0.007) showed a positive correlation with attenuation conversion rate.Hypoattenuating hepatic nodular lesions in chronic liver disease depicted on dynamic CT have high malignant potential and should be followed with special attention to conversion from hypoattenuation to hyperattenuation to determine the optimal timing of treatment. |
| Databáze: | OpenAIRE |
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