Cirrhosis or chronic hepatitis: evaluation of small (<or=2-cm) early-enhancing hepatic lesions with serial contrast-enhanced dynamic MR imaging.
OBJECTIVE
To evaluate the frequency and clinical importance of small (<or=2 cm) early-enhancing hepatic lesions in cirrhotic liver disease with serial multiphasic contrast material-enhanced dynamic magnetic resonance (MR) imaging.


METHODS
The study population included 208 patients with cirrhosis (n = 162) or chronic hepatitis (n = 46) who underwent dynamic contrast-enhanced MR imaging at least twice during the clinical course, with at least a 12-month interval between the initial and latest MR examinations. Initial images were evaluated for the presence and shape of small (<or=2 cm) early-enhancing hepatic lesions at arterial-phase contrast-enhanced MR imaging. If a small early- enhancing lesion was seen on the initial image, the latest follow-up image was reviewed to assess the serial changes in the features of a specific lesion.


RESULTS
One hundred fifty-eight small early-enhancing lesions were detected in 75 (36%) of the 208 patients on the initial MR images. Of those 158 lesions, 104 were round or oval, 30 wedge-shaped, 18 geographic (irregularly shaped), and six triangular. Among the 104 round or oval lesions, 54 (52%) disappeared or decreased in size on the latest MR images and were considered definite pseudolesions. Twenty-nine (28%) of the 104 round or oval lesions were classified as hepatocellular carcinoma (HCC) on the basis of their interval growth or pathologic confirmation. The remaining 21 (20%) lesions were stable in size and appearance and considered probable pseudolesions. For the other three shapes, 73% of wedge-shaped, 78% of geographic, and 67% of triangular lesions disappeared or decreased in size.


CONCLUSIONS
Small early-enhancing hepatic lesions in patients with cirrhosis usually showed no interval growth or disappeared during serial contrast-enhanced dynamic MR imaging. Even though these lesions are round or oval, they may more frequently be pseudolesions than HCCs.
Shimizu
Ayame
A
Department of Radiology, Yamaguchi University School of Medicine, 1-1-1 Minamikogushi, Ube, Yamaguchi 755-8505 Japan. ayamechan51@hotmail.com
Ito
Katsuyoshi
K
Koike
Shinji
S
Fujita
Takeshi
T
Shimizu
Kensaku
K
Matsunaga
Naofumi
N
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D006528:Carcinoma, Hepatocellular / Q000150:complications / Q000175:diagnosis*; D003937:Diagnosis, Differential; D005260:Female; D006521:Hepatitis, Chronic / Q000150:complications*; D006801:Humans; D008103:Liver Cirrhosis / Q000150:complications*; D008113:Liver Neoplasms / Q000150:complications / Q000175:diagnosis*; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies