title: Risk of hypervascularization in small hypovascular hepatic nodules showing hypointense in the hepatobiliary phase of gadoxetic acid-enhanced MRI in patients with chronic liver disease.
abstract: OBJECTIVE
  The purpose of this study was to elucidate the incidence and risk factors for the progression of hypointense nodules observed in the hepatobiliary phase of gadoxetic acid-enhanced magnetic resonance imaging (Gd-EOB-DTPA-enhanced MRI) of hypervascular hepatocellular carcinoma (HCC).
  
  
  METHODS
  Hypovascular nodules (112) showing hypointensity in the hepatobiliary phase of Gd-EOB-DTPA-enhanced MRI were examined in 54 patients. All patients underwent computed tomography during hepatic arteriography and computed tomography during arterial portography (CTAP) within a month after Gd-EOB-DTPA-enhanced MRI. According to the tumor size, 112 nodules were divided into two groups: those >10 mm in diameter (group A, n = 39) and those ≤10 mm in diameter (group B, n = 73). The incidence of progression to hypervascular HCC was calculated using the Kaplan-Meier method.
  
  
  RESULTS
  The incidence of hypervascularization was significantly higher in group A nodules than in group B nodules (p < 0.0001). Tumor size (p < 0.0001) and hypoattenuation in CTAP (p = 0.0004) showed significant correlation with hypervascularization.
  
  
  CONCLUSIONS
  Hypointense nodules observed in the hepatobiliary phase of Gd-EOB-DTPA-enhanced MRI with diameters of >10 mm had a high probability of hypervascularization.
authors.affiliation: Department of Radiology, Ehime University Graduate School of Medicine, Shitsukawa, Toon 791-0295, Japan. megumi@m.ehime-u.ac.jp
authors.forename: Megumi
authors.initials: M
authors.lastname: Takechi
authors.forename: Takaharu
authors.initials: T
authors.lastname: Tsuda
authors.forename: Shinji
authors.initials: S
authors.lastname: Yoshioka
authors.forename: Shigetoshi
authors.initials: S
authors.lastname: Murata
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Tanaka
authors.forename: Masashi
authors.initials: M
authors.lastname: Hirooka
authors.forename: Teruhito
authors.initials: T
authors.lastname: Mochizuki
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D006528:Carcinoma, Hepatocellular / Q000098:blood supply*; D002908:Chronic Disease; D003287:Contrast Media; D018450:Disease Progression; D005260:Female; D019786:Gadolinium DTPA / Q000494:pharmacology*; D006801:Humans; D008107:Liver Diseases / Q000473:pathology*; D008113:Liver Neoplasms / Q000098:blood supply*; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012307:Risk Factors
chemical_list: D003287:Contrast Media; C073590:gadolinium ethoxybenzyl DTPA; D019786:Gadolinium DTPA