Non-hypervascular Hypointense Nodules on Hepatocyte Phase Gadoxetic Acid-Enhanced MR Images: Transformation of MR Hepatobiliary Hypointense Nodules into Hypervascular Hepatocellular Carcinomas
- Author:
Yun Ku CHO
1
;
Ju Won KIM
;
Mi Young KIM
;
Hyeon Je CHO
Author Information
- Publication Type:Original Article
- Keywords: Liver neoplasms; Liver magnetic resonance; Carcinoma; hepatocellular; Malignant transformation
- MeSH: Carcinoma, Hepatocellular; Follow-Up Studies; Hepatocytes; Humans; Liver Neoplasms; Magnetic Resonance Imaging; Multivariate Analysis; Proportional Hazards Models; Retrospective Studies; Risk Factors
- From:Gut and Liver 2018;12(1):79-85
- CountryRepublic of Korea
- Language:English
- Abstract: BACKGROUND/AIMS: The annual risk of transformation of non-hypervascular magnetic resonance (MR) hepatobiliary phase imaging (HBPI) hypointense nodules into hypervascular hepatocellular carcinomas (HCCs) was evaluated. METHODS: Cirrhotic patients with non-hypervascular HBPI hypointense nodules were retrospectively analyzed if they were diagnosed as HCC and MR followed up longer than 1 year during the period from January 2010 to October 2016 with regular intervals of 3 to 6 months. Risk factors for transformation into hypervascular HCCs were analyzed using the Cox proportional hazard model. RESULTS: Among the 103 non-hypervascular HBPI hypointense nodules meeting the inclusion criteria, transformation into hypervascular HCCs occurred in 44 tumors (42.7%). The median follow-up period was 24 months. Multivariate analysis revealed that hyperintensity on T2-weighted images (T2WI) and diffusion-weighted images (DWI) were the two independent predictors of transformation into hypervascular HCCs (p=0.036 and p=0.041, respectively). Most tumors with hyperintensity on T2WI or DWI on the initial or follow-up MR were transformed into hypervascular HCCs within the first year. Among the 22 nodules (21.3%) showing a new change in dynamic phases during follow-up, 14 nodules (13.6%) showed malignant transformations. CONCLUSIONS: The transformation rates of HBPI hypointense nodules into hypervascular HCCs could be predicted according to the initial or serial MRI findings.
