Caroline Rousseau1, Maxime Ronot2,3,4, Valérie Vilgrain5,6,7, Marc Zins1. 1. Department of Radiology, Fondation Hôpital Saint-Joseph, 185 rue Raymond Losserand, 75674, Paris, France. 2. Department of Radiology, Hôpital Beaujon, HUPNVS, 100, Bd du Général Leclerc, Clichy, France. maxime.ronot@aphp.fr. 3. University Paris Diderot, Sorbonne Paris Cite, Paris, France. maxime.ronot@aphp.fr. 4. INSERM U1149, CRI, 75018, Paris, France. maxime.ronot@aphp.fr. 5. Department of Radiology, Hôpital Beaujon, HUPNVS, 100, Bd du Général Leclerc, Clichy, France. 6. University Paris Diderot, Sorbonne Paris Cite, Paris, France. 7. INSERM U1149, CRI, 75018, Paris, France.
Abstract
PURPOSE: To evaluate the qualitative and quantitative benefit of multiple arterial phase acquisitions for the depiction of hypervascularity in FNH explored MR imaging using an extracellular contrast agent. METHODS: Between 2007 and 2014, all patients who underwent MR imaging for the exploration of FNH were included. The protocol included a single or a triple arterial phase ("single" and "triple" group, respectively). Arterial phases were visually divided into four types: (1) angiographic, (2) early, (3) late, and (4) portal. Signal intensity on arterial phase images was visually recorded as intense, moderate, or low for each lesion. Lesion-to-liver contrast (LLC) and relative lesion enhancement (RE) were calculated and compared between the two groups using the Mann-Whitney test. RESULTS: Thirty-five women were included (mean 45-year old, range 20-66), with 50 FNH (mean size 30 mm). Single and triple groups included 20 patients (30 FNH) and 15 patients (20 FNH), respectively. Signal intensity was intense in all lesions in the triple group and in 22/30 (73%) in the single group (p = 0.041). Intense signals were more frequently found in the early arterial phase (p < 0.001). RE was not significantly different (1.78 ± 0.84 vs. 1.98 ± 1.81 p = 0.430, in the single and triple groups, respectively) but LLC was significantly higher in the triple group (0.32 ± 0.10 vs. 0.22 ± 0.10, p = 0.005). LLC was significantly higher in the first two arterial phases in the triple group (p < 0.001). CONCLUSION: Acquisition of three arterial phases improves the visualization of hypervascularity of FNH, as lesions show high visual signal intensity and contrast. Optimal visualization is obtained in the early arterial phase.
PURPOSE: To evaluate the qualitative and quantitative benefit of multiple arterial phase acquisitions for the depiction of hypervascularity in FNH explored MR imaging using an extracellular contrast agent. METHODS: Between 2007 and 2014, all patients who underwent MR imaging for the exploration of FNH were included. The protocol included a single or a triple arterial phase ("single" and "triple" group, respectively). Arterial phases were visually divided into four types: (1) angiographic, (2) early, (3) late, and (4) portal. Signal intensity on arterial phase images was visually recorded as intense, moderate, or low for each lesion. Lesion-to-liver contrast (LLC) and relative lesion enhancement (RE) were calculated and compared between the two groups using the Mann-Whitney test. RESULTS: Thirty-five women were included (mean 45-year old, range 20-66), with 50 FNH (mean size 30 mm). Single and triple groups included 20 patients (30 FNH) and 15 patients (20 FNH), respectively. Signal intensity was intense in all lesions in the triple group and in 22/30 (73%) in the single group (p = 0.041). Intense signals were more frequently found in the early arterial phase (p < 0.001). RE was not significantly different (1.78 ± 0.84 vs. 1.98 ± 1.81 p = 0.430, in the single and triple groups, respectively) but LLC was significantly higher in the triple group (0.32 ± 0.10 vs. 0.22 ± 0.10, p = 0.005). LLC was significantly higher in the first two arterial phases in the triple group (p < 0.001). CONCLUSION: Acquisition of three arterial phases improves the visualization of hypervascularity of FNH, as lesions show high visual signal intensity and contrast. Optimal visualization is obtained in the early arterial phase.
Entities:
Keywords:
Arterial phase; Focal nodular hyperplasia; Magnetic resonance imaging; Multiphasic
Authors: Marco Gatti; Marco Calandri; Laura Bergamasco; Fatemeh Darvizeh; Luigi Grazioli; Riccardo Inchingolo; Davide Ippolito; Stefano Rousset; Andrea Veltri; Paolo Fonio; Riccardo Faletti Journal: Radiol Med Date: 2020-01-08 Impact factor: 3.469