title: Outcome of hypovascular hepatic nodules revealing no gadoxetic acid uptake in patients with chronic liver disease.
abstract: OBJECTIVE
  To elucidate the natural history of hypovascular nodules that appear hypointense on hepatocyte-phase gadoxetic acid-enhanced MR images by focusing on hypervascularization over time.
  
  
  METHODS
  In this study, 135 hypovascular nodules revealing no gadoxetic acid uptake in 53 patients were examined. All nodules were retrospectively examined using serial follow-up computed tomography (CT) and MRI examinations until hypervascularity was observed on arterial-phase dynamic CT or gadoxetic acid-enhanced MR images, or on CT during hepatic arteriography. Logistic regression analysis was used to investigate the association between hypervascularization and MR findings including a presence of fat assessed by a signal drop on opposed-phase T1-weighted images.
  
  
  RESULTS
  Of the 135 nodules, 16 underwent hypervascularization. The size of the nodules and the presence of fat in the nodules were independent indicators of hypervascularization. The 1-year cumulative risk of hypervascularization was 15.6%. This risk was significantly increased in the case of nodules >10 mm (37.6%, P < 0.01) and fat-containing nodules (26.5%, P < 0.01).
  
  
  CONCLUSIONS
  Hypovascular nodules that appear hypointense on hepatocyte-phase gadoxetic acid-enhanced MR images may progress to conventional hypervascular hepatocellular carcinoma. Nodules more than 10 mm in diameter and containing fat are at high risk for developing hypervascularization.
authors: Department of Radiology, University of Yamanashi, Yamanashi, Japan.
authors: Utaroh
authors: U
authors: Motosugi
authors: Tomoaki
authors: T
authors: Ichikawa
authors: Katsuhiro
authors: K
authors: Sano
authors: Hironobu
authors: H
authors: Sou
authors: Kojiro
authors: K
authors: Onohara
authors: Ali
authors: A
authors: Muhi
authors: Fumitake
authors: F
authors: Amemiya
authors: Nobuyuki
authors: N
authors: Enomoto
authors: Masanori
authors: M
authors: Matsuda
authors: Hideki
authors: H
authors: Fujii
authors: Tsutomu
authors: T
authors: Araki