title: Gadoxetic acid enhanced MRI for differentiation of FNH  and HCA: a single centre experience.
abstract: OBJECTIVE
  Evaluation of enhancement characteristics of histopathologically confirmed focal nodular hyperplasias (FNHs) and hepatocellular adenomas (HCAs) with gadoxetic acid-enhanced MRI.
  
  
  METHODS
  Sixty-eight patients with 115 histopathologically proven lesions (FNHs, n=44; HCAs, n=71) examined with gadoxetic acid-enhanced MRI were retrospectively enrolled (standard of reference: surgical resection, n=53 patients (lesions: FNHs, n=37; HCAs, n=53); biopsy, n=15 (lesions: FNHs, n=7; HCAs, n=18)). Two radiologists evaluated all MR images regarding morphological features as well as the vascular and hepatocyte-specific enhancement in consensus.
  
  
  RESULTS
  For the hepatobiliary phase, relative enhancement of the lesions and lesion to liver enhancement were significantly lower for HCAs (mean, 48.7 (±48.4)%and 49.4 (±33.9) %) compared to FNHs (159.3 (±92.5) %; and 151.7 (±79) %; accuracy of 89%and 90 %, respectively; P<0.001). Visual strong uptake of FNHs vs. hypointensity of HCAs in the hepatobiliary phase resulted in an accuracy of 92 %. This parameter was superior to all other morphological and dynamic vascular criteria alone and in combination (accuracy, 54–85 %).
  
  
  CONCLUSIONS
  For differentiation of FNHs and HCAs by means of MRI, gadoxetic acid uptake in the hepatobiliary phase was found to be superior to all other criteria alone and in combination.
  
  
  CONCLUSIONS
  EOB-MRI is well suited to differentiate FNHs and hepatocellular adenomas. For this purpose hepatobiliary phase is superior to unenhanced and dynamic imaging. Hepatobiliary phase (peripheral) hyper- or isointensity is typical for FNH. Hepatobiliary phase hypointensity is typical for hepatocellular adenomas. EOB-MRI helps to avoid misinterpretations of benign hepatocellular lesions.
authors.forename: Christian
authors.initials: C
authors.lastname: Grieser
authors.forename: Ingo G
authors.initials: IG
authors.lastname: Steffen
authors.forename: Incken-Birthe
authors.initials: IB
authors.lastname: Kramme
authors.forename: Hendrik
authors.initials: H
authors.lastname: Bläker
authors.forename: Ergin
authors.initials: E
authors.lastname: Kilic
authors.forename: Carmen Maria
authors.initials: CM
authors.lastname: Perez Fernandez
authors.forename: Daniel
authors.initials: D
authors.lastname: Seehofer
authors.forename: Eckart
authors.initials: E
authors.lastname: Schott
authors.forename: Bernd
authors.initials: B
authors.lastname: Hamm
authors.forename: Timm
authors.initials: T
authors.lastname: Denecke
mesh_terms: D018248:Adenoma, Liver Cell / Q000473:pathology*; D000293:Adolescent; D000328:Adult; D000368:Aged; D001706:Biopsy; D003287:Contrast Media; D003937:Diagnosis, Differential; D005260:Female; D020518:Focal Nodular Hyperplasia / Q000473:pathology*; D019786:Gadolinium DTPA; D006801:Humans; D008102:Liver Circulation; D008113:Liver Neoplasms / Q000473:pathology*; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000473:pathology; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D055815:Young Adult
chemical_list: D003287:Contrast Media; C073590:gadolinium ethoxybenzyl DTPA; D019786:Gadolinium DTPA