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01.10.2014 | Hepatobiliary-Pancreas

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

verfasst von: Atsushi Higaki, Katsuyoshi Ito, Tsutomu Tamada, Teruki Sone, Akihiko Kanki, Yasufumi Noda, Kazuya Yasokawa, Akira Yamamoto

Erschienen in: European Radiology | Ausgabe 10/2014

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Abstract

Purpose

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 and materials

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.

Key Points

• “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.

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Titel: 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
verfasst von: Atsushi Higaki
Katsuyoshi Ito
Tsutomu Tamada
Teruki Sone
Akihiko Kanki
Yasufumi Noda
Kazuya Yasokawa
Akira Yamamoto
Publikationsdatum: 01.10.2014
Verlag: Springer Berlin Heidelberg
Erschienen in: European Radiology / Ausgabe 10/2014
Print ISSN: 0938-7994
Elektronische ISSN: 1432-1084
DOI: https://doi.org/10.1007/s00330-014-3293-8

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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