title: Clinical implication of small (<20 mm) enhancing hepatic nodules observed only during three-dimensional gadobenate dimeglumine-enhanced hepatic arterial-phase MRI of the hepatitis B virus-induced mild cirrhosis.
abstract: OBJECTIVE
  The purpose of this study is to determine the clinical implication of small (<20 mm) enhancing hepatic nodules observed only at three-dimensional gadobenate dimeglumine-enhanced hepatic arterial-phase magnetic resonance imaging (MRI) of the hepatitis B virus-induced mild cirrhosis.
  
  
  METHODS
  Study population included 75 patients (58 men and 17 women; age range, 45-74 years) who had 100 arterial-only enhancing hepatic nodules occult during portal- and equilibrium-phase MRI. All patients had mild liver cirrhosis (Child class A, n=69; B, n=6) associated with viral hepatitis B. Two reviewers analyzed the MRIs in consensus regarding the size, shape, and signal intensity of nodules on the T1- and T2-weighted images.
  
  
  RESULTS
  Of these 100 lesions, 78 and 22 proved to be hepatocellular carcinomas (HCCs) (size range, 0.6-1.9 cm; mean, 1.2 cm) and benign lesions (size range, 0.6-1.9 cm; mean, 1.0 cm), respectively. Most of the lesions (n=98) were oval or round shaped. Thirty-four HCCs were hypointense and/or hyperintense on the T1- and T2-weighted images, respectively. There was a trend toward an increased suspicion of HCC for arterial-only enhancing lesions occult on the portal- and equilibrium-phase and on T1- and T2-weighted MRI (n=44/66 for HCC vs. n=22/66 for benign lesions).
  
  
  CONCLUSIONS
  Small arterial-only enhancing nodules occult on the portal- and equilibrium-phase images as well as on the T1- and T2-weighted images are more likely to be HCC than nonneoplastic hypervascular benign lesions in patients with hepatitis B-induced mild cirrhosis.
authors.affiliation: Department of Diagnostic Radiology, Chonbuk National University Hospital and Medical School, Jeonbuk, South Korea. jmyr@dreamwiz.com
authors.forename: Young Kon
authors.initials: YK
authors.lastname: Kim
authors.forename: Young Hwan
authors.initials: YH
authors.lastname: Lee
authors.forename: Hyo Sung
authors.initials: HS
authors.lastname: Kwak
authors.forename: Chong Soo
authors.initials: CS
authors.lastname: Kim
authors.forename: Young Min
authors.initials: YM
authors.lastname: Han
mesh_terms: D000368:Aged; D006528:Carcinoma, Hepatocellular / Q000150:complications / Q000175:diagnosis*; D003287:Contrast Media; D005260:Female; D005355:Fibrosis / Q000175:diagnosis* / Q000209:etiology*; D006509:Hepatitis B / Q000150:complications / Q000175:diagnosis*; D006801:Humans; D007089:Image Enhancement / Q000379:methods; D007090:Image Interpretation, Computer-Assisted / Q000379:methods; D021621:Imaging, Three-Dimensional / Q000379:methods*; D008099:Liver / Q000473:pathology; D008113:Liver Neoplasms / Q000150:complications / Q000175:diagnosis*; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008536:Meglumine / Q000031:analogs & derivatives*; D008875:Middle Aged; D009942:Organometallic Compounds; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity
chemical_list: D003287:Contrast Media; D009942:Organometallic Compounds; C064572:gadobenic acid; D008536:Meglumine