title: The diagnosis of hypovascular hepatic lesions showing hypo-intensity in the hepatobiliary phase of Gd-EOB- DTPA-enhanced MR imaging in high-risk patients for hepatocellular carcinoma.
abstract: The aim of this study was to evaluate the histologic diagnosis of hypovascular hepatic lesions showing hypointensity on hepatobiliary phase images of gadolinium-ethoxybenzyl-diethylenetriamine pentaacetic acid (Gd-EOB-DTPA)-enhanced MRI (EOB-MRI). In 38 patients with hepatocellular carcinoma (HCC) after curative treatments and 18 patients with liver cirrhosis, 105 hypovascular nodules that were hypointense at the hepatobiliary phase of EOB-MRI were biopsied and the clinical usefulness of these EOB-MRI findings for the diagnosis of HCC was examined. Of the 105 nodules (median diameter = 12mm), 78 (74.3%), 11 (10.5%), and 16 (15.2%) were diagnosed as HCC, dysplastic, and non-neoplastic, respectively. The positive predictive value (PPV) of hypointensity at the hepatobiliary phase of EOB-MRI for the diagnosis of HCC increased to 77-90% when combined with the following factors: washout appearance on the delayed phase of triple-phase CT, hyperintensity in diffusion-weighted image of MRI, or the appearance of a hypoechoic part in ultrasonography. PPV increased to 100% when all 3 factors were positive. A relatively large proportion of hypovascular lesions that showed hypo-intensity in the hepatobiliary phase were confirmed to be HCC, and the accuracy of HCC increased when combined with other imaging findings.
authors: Department of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama 700-8558, Japan. shinnkmr@md.okayama-u.ac.jp
authors: Shinichiro
authors: S
authors: Nakamura
authors: Kazuhiro
authors: K
authors: Nouso
authors: Yoshiyuki
authors: Y
authors: Kobayashi
authors: Hidenori
authors: H
authors: Shiraha
authors: Hideki
authors: H
authors: Ohnishi
authors: Junichi
authors: J
authors: Toshimori
authors: Kenji
authors: K
authors: Kuwaki
authors: Hiroaki
authors: H
authors: Hagihara
authors: Hiroki
authors: H
authors: Takayama
authors: Kazuhide
authors: K
authors: Yamamoto
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D006528:Carcinoma, Hepatocellular / Q000453:epidemiology / Q000473:pathology*; D003287:Contrast Media; D018450:Disease Progression; D005260:Female; D019786:Gadolinium DTPA; D006801:Humans; D008099:Liver / Q000098:blood supply* / Q000473:pathology*; D008103:Liver Cirrhosis / Q000453:epidemiology / Q000473:pathology; D008113:Liver Neoplasms / Q000453:epidemiology / Q000473:pathology*; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D012307:Risk Factors
chemical_list: D003287:Contrast Media; C073590:gadolinium ethoxybenzyl DTPA; D019786:Gadolinium DTPA