Literature DB >> 20677263

Value of delayed hypointensity and delayed enhancing rim in magnetic resonance imaging diagnosis of small hepatocellular carcinoma in the cirrhotic liver.

Asra S Khan1, Hero K Hussain, Timothy D Johnson, William J Weadock, Shawn J Pelletier, Jorge A Marrero.   

Abstract

PURPOSE: To determine the diagnostic utility of delayed hypointensity and delayed enhancing rim on magnetic resonance imaging (MRI) as indicators of hepatocellular carcinoma (HCC) in arterially enhancing nodules < or =5 cm in the cirrhotic liver and determine the features that best predict HCC.
MATERIALS AND METHODS: Gadolinium-enhanced MRI studies performed from January 2001 to December 2004 in patients with cirrhosis were evaluated for arterially enhancing nodules measuring < or =5 cm. Verification was via explant correlation, biopsy, or imaging follow-up. Sensitivity and specificity of diagnostic features of HCC were calculated. Features predictive of HCC were determined using the Generalized Estimating Equation approach.
RESULTS: In all, 116 arterially enhancing nodules were identified in 80 patients (<2 cm: n = 79, 2-5 cm n = 37). Sensitivity and specificity of delayed hypointensity for HCC measuring < or =5 cm, 2-5 cm, and <2 cm were 0.54 (40 of 74) and 0.86 (36 of 42); 0.72 (23 of 32) and 0.80 (4 of 5); and 0.41 (17 of 42) and 0.87 (32 of 37). For the delayed enhancing rim sensitivity and specificity were 0.64 (47 of 74) and 0.86 (36 of 42); 0.75 (24 of 32) and 1.0 (5 of 5); and 0.55 (23 of 42) and 0.83 (31 of 37), respectively. Lesion size (> or =2 cm) and delayed enhancing rim, as main features and their interaction, were the most significant predictors of HCC.
CONCLUSION: Delayed hypointensity and enhancing rim improve the specificity of diagnosis of HCC of all sizes but are seen less frequently in small (<2 cm) HCC. Nodule size (> or =2 cm) and delayed enhancing rim are the strongest predictors of HCC. 2010 Wiley-Liss, Inc.

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Year:  2010        PMID: 20677263     DOI: 10.1002/jmri.22271

Source DB:  PubMed          Journal:  J Magn Reson Imaging        ISSN: 1053-1807            Impact factor:   4.813


  28 in total

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Review 10.  Evidence Supporting LI-RADS Major Features for CT- and MR Imaging-based Diagnosis of Hepatocellular Carcinoma: A Systematic Review.

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