title: Prognosis of small hepatocellular nodules detected only at the hepatobiliary phase of Gd-EOB-DTPA-enhanced MR imaging as hypointensity in cirrhosis or chronic hepatitis.
abstract: OBJECTIVE
  To evaluate the prognosis of "strict" high-risk nodules (small hepatocellular nodules detected only in the hepatobiliary phase of initial Gd-EOB-DTPA-enhanced MR examination) in patients with cirrhosis or chronic hepatitis.
  
  
  METHODS
  The study included thirty-three patients with 60 "strict" high-risk nodules showing hypointensity at the hepatobiliary phase that was undetectable at the vascular phase and other conventional sequences of initial Gd-EOB-DTPA-enhanced MR imaging. These nodules were observed on follow-up MR examinations until hypervascularity was detected. The potential predictive factors for hypervascular transformation were compared between two groups (group A showing hypervascular transformation, group B not showing hypervascularization).
  
  
  RESULTS
  Ten (16.7 %) of 60 "strict" high-risk nodules showed hypervascular transformation during follow-up periods (group A). The growth rates of the nodules in group A (6.3 ± 4.5 mm/year) were significantly higher than those in group B (3.4 ± 7.2 mm/year) (p = 0.003). Additionally, the median observation period in group A (177.5 ± 189.5 day) was significantly shorter than in group B (419 ± 372.2 day) (p = 0.045). The other predictive factors were not significantly correlated with hypervascularization.
  
  
  CONCLUSIONS
  Subsets of "strict" high-risk nodules showed hypervascular transformation during follow-up periods in association with increased growth rates, indicating that nodule growth rate is an important predictive factor for hypervascularization.
  
  
  CONCLUSIONS
  • "Strict" high-risk nodules are defined as hepatocellular nodules detected only in the hepatobiliary-phase. • Subsets of "strict" high-risk nodules showed hypervascular transformation during follow-up periods. • Increased growth rate is an important predictive factor for hypervascular transformation. • Management of patients with "strict" high-risk nodules becomes more appropriate.
authors.affiliation: Department of Radiology, Kawasaki Medical School, 577 Matsushima, Kurashiki City, Okayama, 701-0192, 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: Teruki
authors.initials: T
authors.lastname: Sone
authors.forename: Akihiko
authors.initials: A
authors.lastname: Kanki
authors.forename: Yasufumi
authors.initials: Y
authors.lastname: Noda
authors.forename: Kazuya
authors.initials: K
authors.lastname: Yasokawa
authors.forename: Akira
authors.initials: A
authors.lastname: Yamamoto
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D006528:Carcinoma, Hepatocellular / Q000175:diagnosis*; D003287:Contrast Media; D003937:Diagnosis, Differential; D005260:Female; D019786:Gadolinium DTPA; D006521:Hepatitis, Chronic / Q000175:diagnosis*; D006801:Humans; D007089:Image Enhancement / Q000379:methods*; D008099:Liver / Q000473:pathology; D008103:Liver Cirrhosis / Q000175:diagnosis*; D008113:Liver Neoplasms / Q000175:diagnosis*; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012189:Retrospective Studies
chemical_list: D003287:Contrast Media; C073590:gadolinium ethoxybenzyl DTPA; D019786:Gadolinium DTPA