alexa Outcome of hypovascular hepatic nodules revealing no gadoxetic acid uptake in patients with chronic liver disease.


Journal of Liver

Author(s): Motosugi U, Ichikawa T, Sano K, Sou H, Onohara K,

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Abstract PURPOSE: To elucidate the natural history of hypovascular nodules that appear hypointense on hepatocyte-phase gadoxetic acid-enhanced MR images by focusing on hypervascularization over time. MATERIALS AND METHODS: In this study, 135 hypovascular nodules revealing no gadoxetic acid uptake in 53 patients were examined. All nodules were retrospectively examined using serial follow-up computed tomography (CT) and MRI examinations until hypervascularity was observed on arterial-phase dynamic CT or gadoxetic acid-enhanced MR images, or on CT during hepatic arteriography. Logistic regression analysis was used to investigate the association between hypervascularization and MR findings including a presence of fat assessed by a signal drop on opposed-phase T1-weighted images. RESULTS: Of the 135 nodules, 16 underwent hypervascularization. The size of the nodules and the presence of fat in the nodules were independent indicators of hypervascularization. The 1-year cumulative risk of hypervascularization was 15.6\%. This risk was significantly increased in the case of nodules >10 mm (37.6\%, P < 0.01) and fat-containing nodules (26.5\%, P < 0.01). CONCLUSION: Hypovascular nodules that appear hypointense on hepatocyte-phase gadoxetic acid-enhanced MR images may progress to conventional hypervascular hepatocellular carcinoma. Nodules more than 10 mm in diameter and containing fat are at high risk for developing hypervascularization. Copyright © 2011 Wiley-Liss, Inc. This article was published in J Magn Reson Imaging and referenced in Journal of Liver

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