Differentiating malignant from benign hyperintense nodules on unenhanced T1-weighted images in patients with chronic liver disease: using gadoxetic acid-enhanced and diffusion-weighted MR imaging
- Authors
- Moon, Ji Yoon; Kim, Seong Hyun; Choi, Seo-Youn; Hwang, Jeong Ah; Lee, Ji Eun; Lee, Jisun
- Issue Date
- Aug-2018
- Publisher
- Springer Verlag
- Keywords
- Magnetic resonance imaging; Diffusion magnetic resonance imaging; Hepatocellular carcinoma; Apparent diffusion coefficient
- Citation
- Japanese Journal of Radiology, v.36, no.8, pp 489 - 499
- Pages
- 11
- Journal Title
- Japanese Journal of Radiology
- Volume
- 36
- Number
- 8
- Start Page
- 489
- End Page
- 499
- URI
- https://scholarworks.bwise.kr/sch/handle/2021.sw.sch/5785
- DOI
- 10.1007/s11604-018-0748-x
- ISSN
- 1867-1071
- Abstract
- Purpose To evaluate value of gadoxetic acid-enhanced and diffusion-weighted (DW) MRI for distinguishing malignant from benign hyperintense nodules on unenhanced T1-weighted images (T1WIs) in patients with chronic liver disease. Materials and methods Forty-two patients with 37 malignant and 41 benign hyperintense nodules on unenhanced T1WIs who underwent gadoxetic acid-enhanced and DW MRI, followed by histopathological examination, were included. Qualitative and quantitative analyses were conducted. Significant findings on univariate and multivariate analyses were identified and their diagnostic performances were analyzed for predicting hyperintense hepatocellular carcinomas (HCCs). Results In univariate analysis, hyperintensity on T2WI, arterial enhancement, washout, hypointensity on hepatobiliary phase, and diffusion restriction were more frequently observed (P < 0.05) in hyperintense HCCs. Tumor-to-liver SI ratio on hepatobiliary phase and minimum apparent diffusion coefficient (ADC(min)) were significantly lower in hyperintense HCCs (P < 0.05). In multivariate analysis, hyperintensity on T2WI (OR, 13.58; P = 0.02), arterial enhancement (OR, 8.21; P = 0.002), and ADC(min) <= 0.83 x 10(-3) mm(2)/s (OR, 6.88; P = 0.008) were independently significant factors for predicting hyperintense HCCs. When two of three criteria were combined, 75.7% (28/37) of hyperintense HCCs were identified with a specificity of 92.7%, and when all three criteria were satisfied, the specificity was 97.6%. Conclusion Gadoxetic acid-enhanced and DW MRI may be helpful for differentiating malignant from benign hyperintense nodules on unenhanced T1WI.
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Collections - College of Medicine > Department of Radiology > 1. Journal Articles
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