Characterization of hyperintense nodules on precontrast T1-weighted MRI: Utility of gadoxetic acid-enhanced hepatocyte-phase imaging

✍ Scribed by Chen-Te Chou; Yao-Li Chen; Hwa-Koon Wu; Ran-Chou Chen

• Publisher: John Wiley and Sons
• Year: 2011
• Tongue: English
• Weight: 364 KB
• Volume: 33
• Category: Article
• ISSN: 1053-1807
• DOI: 10.1002/jmri.22500

✦ Synopsis

Abstract

Purpose:

To evaluate the utility of gadoxetic acid‐enhanced hepatocyte‐phase magnetic resonance imaging (MRI) in characterization of T1‐weighted hyperintense nodules within cirrhotic liver.

Materials and Methods:

This retrospective study was approved by our Institutional Review Board. Thirty‐four nodules hyperintense in unenhanced T1‐weighted MRI with histopathological confirmation from a collection of 19 patients were included. Tumor size, signal intensity on T1‐weighted, and T2‐weighted imaging as well as enhancement patterns on contrast‐enhanced dynamic/hepatocyte‐phase imaging were recorded. Receiver operating characteristic (ROC) analysis was used to evaluate the diagnostic performance of hepatocyte‐phase imaging.

Results:

Evaluation of the nodules with standard of reference revealed 15 dysplastic nodules (DN), seven well‐differentiated hepatocellular carcinomas (wHCC), and 12 moderately differentiated HCCs (mHCC). The mean size of dysplastic nodules was smaller than that of HCCs (P < 0.001). Using the HCC criteria (T2W or arterial enhancement followed with portal venous washout), 11/19 HCC were correctly characterized. Using solely hypointensity (compared to the surrounding liver parenchyma) during the hepatocyte phase as the criterion, 18/19 HCC were correctly characterized. There were seven additional HCCs diagnosed with hepatocyte‐phase imaging (P = 0.02).

Conclusion:

Gadoxetic acid‐enhanced MRI with hepatocyte‐phase imaging is superior to gadoxetic acid‐enhanced MRI with conventional criteria alone in characterization of T1W hyperintense nodules. J. Magn. Reson. Imaging 2011;33:625–632. © 2011 Wiley‐Liss, Inc.