Validation of diagnostic criteria using gadoxetic acid-enhanced and diffusion-weighted MR imaging for small hepatocellular carcinoma (≤ 2.0 cm) in patients with hepatitis-induced liver cirrhosis
| Autor: | Min Jung Park, Jiyoung Hwang Won Jae Lee, Mi Hee Lee, Young Kon Kim |
|---|---|
| Rok vydání: | 2013 |
| Předmět: |
Adult
Gadolinium DTPA Liver Cirrhosis Male Gadoxetic acid medicine.medical_specialty Carcinoma Hepatocellular Cirrhosis Hepatitis Viral Human Contrast Media Sensitivity and Specificity Diagnosis Differential Multidetector Computed Tomography medicine Carcinoma Humans Radiology Nuclear Medicine and imaging Aged Observer Variation Hepatitis Radiological and Ultrasound Technology medicine.diagnostic_test business.industry Liver Neoplasms Magnetic resonance imaging General Medicine Middle Aged medicine.disease Hyperintensity Diffusion Magnetic Resonance Imaging Hepatocellular carcinoma Chronic Disease Female Radiology Nuclear medicine business medicine.drug Diffusion MRI |
| Zdroj: | Acta Radiologica. 54:127-136 |
| ISSN: | 1600-0455 0284-1851 |
| DOI: | 10.1258/ar.2012.120262 |
| Popis: | Background Gadoxetic acid and diffusion-weighted imaging (DWI) is increasingly used for the diagnosis of hepatocellular carcinoma (HCC). It is relevant to refine the diagnostic parameters for HCC, using state-of-the-art imaging techniques. Purpose To validate usefulness of magnetic resonance imaging (MRI) criteria with gadoxetic acid-enhanced MRI and DWI for diagnosis of small HCC by differentiation from dysplastic nodule (DN) or regenerative nodule (RN) in cirrhotic patients with strongly suspected small HCC. Material and Methods One hundred and eight patients with 102 HCCs and 29 benign nodules including 21 DNs and two large RNs (≤ 2.0 cm), and 40 patients with no HCC underwent gadoxetic acid-enhanced MRI and DWI. All patients also underwent MDCT. Index MR criteria for HCC were: (i) arterial hyperenhancement and hypointensity on hepatobiliary phase (HBP) with hyperintensity on DWI; (ii) hypovascular nodule with hyperintensity on DWI; (iii) arterial hyperenhancement and hypointensity on HBP without hyperintensity on DWI; (iv) arterial hyperenhancement and either iso- or hyperintensity on HBP, with hyperintensity on DWI; and (v) hyperintensity only on DWI. According to these criteria, MRI findings for HCCs and benign nodules were independently classified by two reviewers. Results On multidetector-row computed tomography, 64 HCCs (62.7%) showed typical features for HCC while 13 (12.8%) were not identified. On MRI, 84 HCCs (82.4%) showed arterial hyperenhancement and hypointensity on HBP, and hyperintensity on DWI. Eight HCCs were regarded as hypovascular HCCs with hyperintensity DWI (category 2). One HCC (0.6 cm in diameter) was demonstrated only by DWI. For each observer, 101 (99.0%) and 100 HCCs (98.0%) were discernible when applying all MRI criteria for HCC, respectively. Three DNs also fit the HCC criteria, thus the specificity was 90.9% for both observers. Conclusion With the HCC criteria based on combined gadoxetic acid-enhanced MRI and DWI, it is possible to reliably diagnose small HCC including hypovascular HCCs. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|