Adenomatous hyperplastic nodules in the cirrhotic liver: differentiation from hepatocellular carcinoma with MR imaging.

Matsui, Osamu; Kadoya, Masumi; Kameyama, Tadamitsu; Yoshikawa, Jun; Arai, Kuniaki; Gabata, Toshifumi; Takashima, Tsutomu; Nakanuma, Yasuni; Terada, Tadashi; Ida, Masahiro

doi:10.1148/radiology.173.1.2550995

Cited by 193 publications

(89 citation statements)

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“…Hyperintensity of HCC on T2-weighted images may be related to dedifferentiation of hepatocellular nodules (23,24). Dysplastic nodules are rarely hyperintense on T2-weighted images unless they are infarcted (10).…”

Section: Discussionmentioning

confidence: 99%

Gadoxetic acid‐enhanced MRI findings of early hepatocellular carcinoma as defined by new histologic criteria

Rhee

Kim

Park

et al. 2011

Magnetic Resonance Imaging

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Purpose: To describe the imaging features of early hepatocellular carcinoma (HCC) on gadoxetic acid-enhanced MRI (Gd-EOB-MRI) in comparison with multidetector computed tomography (MDCT) examinations. Materials and Methods:We analyzed imaging findings of 19 pathologically proven early HCC lesions in 15 patients who underwent both MDCT and Gd-EOB-MRI at 3.0 Tesla (T) units before surgery. MRI included in-phase and outof-phase T1-weighted dual-echo gradient-recalled-echo sequences, dynamic T1-weighted images before and after bolus injection of gadoxetic acid disodium, fat-saturated T2-weighted fast spin-echo sequences, and T1-weighted hepatobiliary phase images 20 min after contrast injection. Two radiologists retrospectively evaluated the signal intensities and enhancement features on MRI and MDCT.Results: None of the lesions displayed arterial enhancement and washout on MDCT. On Gd-EOB-MRI, six (32%) lesions showed T2-hyperintensity, five (26%) lesions showed signal drop on opposed-phase. Three lesions (16%) showed arterial enhancement and washout. Twelve (63%), 13 (68%), and 15 (79%) lesions were hypointense on hepatic venous, equilibrium, and hepatobiliary phase, respectively. Conclusion:Most early HCCs did not show arterial enhancement and washout pattern on both MDCT and Gd-EOB-MRI. Gd-EOB-MRI may provide several ancillary findings for diagnosis of early HCC such as decreased hepatobiliary uptake, T2 hyperintensity and signal drop in opposed phase.

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Section: Discussionmentioning

confidence: 99%

Gadoxetic acid‐enhanced MRI findings of early hepatocellular carcinoma as defined by new histologic criteria

Rhee

Kim

Park

et al. 2011

Magnetic Resonance Imaging

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“…Previously, the imaging findings of HCC have been described by several authors who also evaluated the imaging findings of smaller lesions (5,12,(21)(22)(23). Yamashita et al (24) evaluated the histological subtypes and differentiation degree of HCC in correlation with dynamics enhancement patterns, illustrating a correlation between degree and pattern of enhancement with tumor differentiation and internal architecture.…”

Section: Discussionmentioning

confidence: 99%

“…Classically, the MR imaging features of HCC included high SI on (conventional) T2w sequences (12,13), arterial enhancement, and washout with capsular enhancement in the delayed phase (6,13). However, based on our own experience as well as observations of others (13), MR imaging features of especially smaller HCC may be more variable on currently used T2w FSE and dynamic gadolinium-enhanced sequences.…”

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confidence: 94%

MR imaging of hepatocellular carcinoma: Relationship between lesion size and imaging findings, including signal intensity and dynamic enhancement patterns

Bos

Hussain

Dwarkasing

et al. 2007

Magnetic Resonance Imaging

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Purpose: To assess the relationship between lesion size and MR imaging findings of pathologically-proven hepatocellular carcinoma (HCC). Materials and Methods:In a retrospective, single-center study, 37 consecutive patients were identified between 1999 and 2005 that underwent preoperative MRI and surgical resection of HCC. A total of 47 lesions (mean size ϭ 6.85 cm, range ϭ 1-25 cm) were assessed for signal intensity (SI), enhancement patterns, and secondary morphologic features. Interobserver rating, percentage enhancement, and contrast-to-noise-ratio (CNR) were determined. Lesions were assessed for combinations of typical MRI features. Regression analysis was used to assess relations between MRI findings and tumor size. Results:On fat-suppressed T2-weighted (T2w) fast-spinecho, smaller lesions had lower SI compared to larger lesions (P Ͻ 0.05). In the arterial phase, smaller lesions showed significantly higher percentage enhancement compared to larger lesions (P Ͻ 0.05). In the delayed phase, smaller lesions showed less pronounced washout (P Ͻ 0.05). Heterogeneity of the lesions, including fatty infiltration, internal nodules, or mosaic pattern, was observed significantly more frequently in larger lesions (P Ͻ 0.001). The classic combination of high T2w signal, strong arterial enhancement, and delayed phase washout was present in 23 of 44 lesions (52%). Conclusion:Smaller HCC often showed lower SI on T2w, more intense arterial enhancement, and less pronounced delayed washout compared to larger HCC.

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“…As mosaic architecture is uncommon in small HCCs (46,131), the incremental value of this in 77% of HCCs larger than 3 cm (136). By comparison, cirrhotic nodules and dysplastic nodules characteristically are isointense or hypointense on T2-weighted images and rarely show mild-moderate T2 hyperintensity (137). Thus, mildmoderate hyperintensity in a nodule in a cirrhotic liver on T2-weighted images is highly suggestive of malignancy (137).…”

Section: Ancillary Features That Favor the Diagnosis Of Malignancy Bumentioning

confidence: 99%

CT and MR Imaging Diagnosis and Staging of Hepatocellular Carcinoma: Part II. Extracellular Agents, Hepatobiliary Agents, and Ancillary Imaging Features

Choi¹,

Lee²,

Sirlin³

2014

Radiology

465

385

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Computed tomography (CT) and magnetic resonance (MR) imaging play critical roles in the diagnosis and staging of hepatocellular carcinoma (HCC). The second article of this two-part review discusses basic concepts of diagnosis and staging, reviews the diagnostic performance of CT and MR imaging with extracellular contrast agents and of MR imaging with hepatobiliary contrast agents, and examines in depth the major and ancillary imaging features used in the diagnosis and characterization of HCC.q RSNA, 2014

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Adenomatous hyperplastic nodules in the cirrhotic liver: differentiation from hepatocellular carcinoma with MR imaging.

Cited by 193 publications

References 0 publications

Gadoxetic acid‐enhanced MRI findings of early hepatocellular carcinoma as defined by new histologic criteria

Gadoxetic acid‐enhanced MRI findings of early hepatocellular carcinoma as defined by new histologic criteria

MR imaging of hepatocellular carcinoma: Relationship between lesion size and imaging findings, including signal intensity and dynamic enhancement patterns

CT and MR Imaging Diagnosis and Staging of Hepatocellular Carcinoma: Part II. Extracellular Agents, Hepatobiliary Agents, and Ancillary Imaging Features

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