MRI characteristics for the differential diagnosis of benign and malignant small solitary hypovascular hepatic nodules.
OBJECTIVE
To compare the MRI findings of benign and malignant solitary hypovascular hepatic nodules and identify the differentiating features.


METHODS
A total of 135 patients with solitary hypovascular hepatic lesions up to 3 cm (mass forming intrahepatic cholangiocarcinoma, n=29; metastases, n=26; inflammatory pseudotumors and solitary necrotic nodule, n=48; and hemangioma, n=32) were assessed. MRI findings were analyzed, and lesions were scored for peripheral and intratumoral appearance and enhancement patterns.


RESULTS
Univariate and multivariate analyses showed that the most common findings for benign lesions were subcapsular, sharp margin, homogeneous, marked high signal on T2WI, mild hyperintensity on T2WI, increasing intensity of peripheral globular enhancement, and persistent central septum-like linear enhancement on delayed phase (P<0.05). An area under the curve of 0.955 was obtained for differentiating malignant from benign nodules using the combined imaging features of ill-defined margins, heterogeneity, decreasing intensity of peripheral rim-like enhancement, and central increasing intensity of patchy enhancement. Interobserver agreement was good, ranging from 0.72 to 1.00.


CONCLUSIONS
MRI may be a useful noninvasive method for determining whether hypovascular hepatic nodules are malignant or benign.
Department of Radiology, Huadong Hospital, Fudan University, Shanghai, China.
Haizhen
H
Qian
Shihong
S
Li
Ming
M
Ji
Guangwu
G
Lin
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001650:Bile Duct Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology; D018281:Cholangiocarcinoma / Q000000981:diagnostic imaging / Q000473:pathology; D003937:Diagnosis, Differential; D005260:Female; D006104:Granuloma, Plasma Cell / Q000000981:diagnostic imaging / Q000473:pathology; D006391:Hemangioma / Q000000981:diagnostic imaging / Q000473:pathology; D006801:Humans; D007090:Image Interpretation, Computer-Assisted / Q000379:methods; D008113:Liver Neoplasms / Q000098:blood supply / Q000000981:diagnostic imaging* / Q000473:pathology; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D055815:Young Adult