Small (<20 mm) Enhancing Hepatic Nodules Seen on Arterial Phase MR Imaging of the Cirrhotic Liver: Clinical Implications

作者：Yong Yeon Jeong, Donald G. Mitchell, Tamotsu Kamishima · 发表于：American Journal of Roentgenology · 年份：2002 · DOI：10.2214/ajr.178.6.1781327 · 被引用次数：125 · 研究领域：Hepatocellular Carcinoma Treatment and Prognosis、Liver Disease Diagnosis and Treatment、Liver Disease and Transplantation

OBJECTIVE: To determine the significance in patients with cirrhosis of small (<20 mm) hepatic nodules that show no hyperintensity on T2-weighted MR images but that enhance during arterial phase MR imaging, we reviewed the cases of patients with such nodules. MATERIALS AND METHODS: Our review of radiology reports yielded 68 nodules in 40 patients with cirrhosis that showed no hyperintensity on T2-weighted MR images but had rapid enhancement during arterial phase MR imaging after administration of a gadolinium contrast agent. Thirty-four patients (60 nodules) had multiple follow-up MR imaging examinations (range of length of follow-up, 1-72 months; average length of follow-up, 15 months 2 weeks). The final diagnosis of the nodule was determined by pathology reports or after at least 2 years of follow-up to ensure nodule stability and, therefore, benignity. Two radiologists independently reviewed MR images of the nodules, noting the size, signal intensity on T1- or T2-weighted images, and homogeneity of contrast enhancement. RESULTS: Nine (13%) of the 68 nodules were hepatocellular carcinomas (HCCs). The size of nodules on the first MR examination was between 4 and 20 mm (mean size, 9.5 mm). No significant correlation between the diagnosis of HCC and nodule signal intensity (p = 0.48) or contrast enhancement homogeneity (p = 0.56) on first MR examination was found. Positive predictive value (PPV) and negative predictive value (NPV) for diagnosing HCC on the basis of nodule growt...