title: High-risk nodules detected in the hepatobiliary phase of Gd-EOB-DTPA-enhanced MR imaging in cirrhosis or chronic hepatitis: incidence and predictive factors for hypervascular transformation, preliminary results.
abstract: OBJECTIVE
  To evaluate the incidence and predictive factors of hypervascular transformation during follow-up of "high-risk nodules" detected in the hepatobiliary phase of initial Gd-EOB-DTPA-enhanced MRI in chronic liver disease patients.
  
  
  METHODS
  A total of 109 patients with chronic liver disease who underwent Gd-EOB-DTPA-enhanced MRI several times were investigated. Of these, 43 patients had 76 high-risk nodules with both hypointensity in the hepatobiliary phase and hypovascularity in the arterial phase of initial MRI. These nodules were observed until hypervascularity was detected. MRI and clinical findings were compared to assess the incidence and potential predictive factors for hypervascular transformation between the group showing hypervascular transformation and the group not showing hypervascularization.
  
  
  RESULTS
  The median observation period was 242.5 ± 203.2 days (range, 47-802 days). Overall, 24 of 76 high-risk nodules (31.6%) showed hypervascular transformation during follow-up (median observation period, 186.0 ± 190.3 days). The growth rate of the nodules (P < 0.001), the presence of fat within nodules (P = 0.037), and hyperintensity on T1-weighted images (P = 0.018) were significantly correlated with hypervascularization.
  
  
  CONCLUSIONS
  Subsets of high-risk nodules tended to show hypervascular transformation during follow-up, with an increased growth rate, the presence of fat, and hyperintensity on T1-weighted images as predictive factors.
authors.affiliation: Department of Radiology, Kawasaki Medical School, Kurashiki, Japan. ahah@med.kawasaki-m.ac.jp
authors.forename: Atsushi
authors.initials: A
authors.lastname: Higaki
authors.forename: Katsuyoshi
authors.initials: K
authors.lastname: Ito
authors.forename: Tsutomu
authors.initials: T
authors.lastname: Tamada
authors.forename: Sone
authors.initials: S
authors.lastname: Teruki
authors.forename: Akira
authors.initials: A
authors.lastname: Yamamoto
authors.forename: Hiroki
authors.initials: H
authors.lastname: Higashi
authors.forename: Akihiko
authors.initials: A
authors.lastname: Kanki
authors.forename: Tomohiro
authors.initials: T
authors.lastname: Sato
authors.forename: Yasufumi
authors.initials: Y
authors.lastname: Noda
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002471:Cell Transformation, Neoplastic / Q000473:pathology; D015897:Comorbidity; D003287:Contrast Media; D005260:Female; D019786:Gadolinium DTPA; D006521:Hepatitis, Chronic / Q000453:epidemiology / Q000473:pathology*; D006801:Humans; D015994:Incidence; D007564:Japan / Q000453:epidemiology; D008103:Liver Cirrhosis / Q000453:epidemiology / Q000473:pathology*; D008113:Liver Neoplasms / Q000453:epidemiology / Q000473:pathology*; D008279:Magnetic Resonance Imaging / Q000706:statistics & numerical data*; D008297:Male; D008875:Middle Aged; D009389:Neovascularization, Pathologic / Q000453:epidemiology / Q000473:pathology*; D010865:Pilot Projects; D011379:Prognosis; D015203:Reproducibility of Results; D018570:Risk Assessment; D012680:Sensitivity and Specificity
chemical_list: D003287:Contrast Media; C073590:gadolinium ethoxybenzyl DTPA; D019786:Gadolinium DTPA