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Erschienen in: European Radiology 6/2014

01.06.2014 | Magnetic Resonance

Gadoxetic acid enhanced MRI for differentiation of FNH and HCA: a single centre experience

verfasst von: Christian Grieser, Ingo G. Steffen, Incken-Birthe Kramme, Hendrik Bläker, Ergin Kilic, Carmen Maria Perez Fernandez, Daniel Seehofer, Eckart Schott, Bernd Hamm, Timm Denecke

Erschienen in: European Radiology | Ausgabe 6/2014

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Abstract

Objectives

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.

Key Points

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.
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Metadaten
Titel
Gadoxetic acid enhanced MRI for differentiation of FNH and HCA: a single centre experience
verfasst von
Christian Grieser
Ingo G. Steffen
Incken-Birthe Kramme
Hendrik Bläker
Ergin Kilic
Carmen Maria Perez Fernandez
Daniel Seehofer
Eckart Schott
Bernd Hamm
Timm Denecke
Publikationsdatum
01.06.2014
Verlag
Springer Berlin Heidelberg
Erschienen in
European Radiology / Ausgabe 6/2014
Print ISSN: 0938-7994
Elektronische ISSN: 1432-1084
DOI
https://doi.org/10.1007/s00330-014-3144-7

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