title: The value of Gd-EOB-DTPA-enhanced MR imaging in characterizing cirrhotic nodules with atypical enhancement on Gd-DTPA-enhanced MR images.
abstract: OBJECTIVE
  To evaluate the utility of Gd-EOB-DTPA-enhanced magnetic resonance imaging (MRI) in characterizing atypically enhanced cirrhotic nodules detected on conventional Gd-DTPA-enhanced MR images.
  
  
  METHODS
  We enrolled 61 consecutive patients with 88 atypical nodules seen on conventional Gd-DTPA-enhanced MR images who underwent Gd-EOB-DTPA-enhanced MRI within a 3-month period. Using a reference standard, we determined that 58 of the nodules were hepatocellular carcinoma (HCC) and 30 were dysplastic nodules (DNs). Tumor size, signal intensity on precontrast T1-weighted images (T1WI), T2-weighted images (T2WI) and diffusion-weighted images (DWI), and the enhancement patterns seen on dynamic phase and hepatocyte phase images were determined.
  
  
  RESULTS
  There were significant differences between DNs and HCC in hyperintensity on T2WI, hypointensity on T1WI, hypervascularity on arterial phase images, typical HCC enhancement patterns on dynamic MR images, hypointensity on hepatocyte phase images, and hyperintensity on DWI. The sensitivity and specificity were 79.3% and 83.3% for T2WI, 50.0% and 80.0% for T1WI, 82.8% and 76.7% for DWI, 17.2% and 100% for dynamic MR imaging, 93.1% and 83.3% for hepatocyte phase imaging, and 46.8% and 100% when arterial hypervascularity was combined with hypointensity on hepatocyte-phase imaging.
  
  
  CONCLUSIONS
  Gd-EOB-DTPA-enhanced hepatocyte phase imaging is recommended for patients at high risk for HCC who present with atypical lesions on conventional Gd-DTPA-enhanced MR images.
authors.affiliation: Department of Biomedical Imaging and Radiological Sciences, National Yang-Ming University, Taipei City, Taiwan.|Department of Radiology, China Medical University Hospital, Taichung City, Taiwan.
authors.forename: Yi-Chun
authors.initials: YC
authors.lastname: Wang
authors.affiliation: Department of Biomedical Imaging and Radiological Sciences, National Yang-Ming University, Taipei City, Taiwan.|Department of Radiology, Changhua Christian Hospital, Changhua City, Taiwan.|School of Medicine, Kaohsiung Medical University, Kaohsiung City, Taiwan.
authors.forename: Chen-Te
authors.initials: CT
authors.lastname: Chou
authors.affiliation: Department of Biomedical Imaging and Radiological Sciences, National Yang-Ming University, Taipei City, Taiwan.
authors.forename: Ching-Po
authors.initials: CP
authors.lastname: Lin
authors.affiliation: School of Medicine, Kaohsiung Medical University, Kaohsiung City, Taiwan.|Department of Surgery, Changhua Christian Hospital, Changhua City, Taiwan.
authors.forename: Yao-Li
authors.initials: YL
authors.lastname: Chen
authors.affiliation: Department of Radiology, Changhua Christian Hospital, Changhua City, Taiwan.
authors.forename: Yung-Fang
authors.initials: YF
authors.lastname: Chen
authors.affiliation: Department of Biomedical Imaging and Radiological Sciences, National Yang-Ming University, Taipei City, Taiwan.|Health Promotion Administration, Ministry of Health and Welfare, Taipei City, Taiwan.
authors.forename: Ran-Chou
authors.initials: RC
authors.lastname: Chen
mesh_terms: D000368:Aged; D006528:Carcinoma, Hepatocellular / Q000175:diagnosis / Q000000981:diagnostic imaging*; D003287:Contrast Media; D038524:Diffusion Magnetic Resonance Imaging / Q000379:methods; D005260:Female; D019786:Gadolinium DTPA; D022781:Hepatocytes / Q000473:pathology; D006801:Humans; D007089:Image Enhancement / Q000379:methods*; D008103:Liver Cirrhosis / Q000175:diagnosis / Q000000981:diagnostic imaging*; D008113:Liver Neoplasms / Q000175:diagnosis / Q000000981:diagnostic imaging*; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D015203:Reproducibility of Results; D012189:Retrospective Studies; D012680:Sensitivity and Specificity
chemical_list: D003287:Contrast Media; C073590:gadolinium ethoxybenzyl DTPA; D019786:Gadolinium DTPA