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

Shinichiro Nakamura, Kazuhiro Nouso, Yoshiyuki Kobayashi, Hidenori Shiraha, Hideki Ohnishi, Junichi Toshimori, Kenji Kuwaki, Hiroaki Hagihara, Hiroki Takayama, Kazuhide Yamamoto

Research output: Contribution to journalArticle

8 Citations (Scopus)

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.

Original languageEnglish
Pages (from-to)239-244
Number of pages6
JournalActa medica Okayama
Volume67
Issue number4
Publication statusPublished - 2013

Keywords

  • Diagnosis
  • Gadolinium-ethoxybenzyl-diethylenetriamine pentaacetic acid
  • Hepatocellular carcinoma
  • Hypovascular
  • Magnetic resonance imaging

ASJC Scopus subject areas

  • Biochemistry, Genetics and Molecular Biology(all)

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