Diagnostic criteria for hepatocellular carcinoma ≤3 cm with hepatocyte-specific contrast-enhanced magnetic resonance imaging

被引：92

作者：

Choi, Sang Hyun ^{[1
,2
]}

Byun, Jae Ho ^{[1
,2
]}

Lim, Young-Suk ^{[3
]}

Yu, Eunsil ^{[4
]}

Lee, So Jung ^{[1
,2
]}

Kim, So Yeon ^{[1
,2
]}

Won, Hyung Jin ^{[1
,2
]}

Shin, Yong Moon ^{[1
,2
]}

Kim, Pyo Nyun ^{[1
,2
]}

机构：

[1] Univ Ulsan, Coll Med, Asan Med Ctr, Dept Radiol, 88 Olymp Ro,43 Gil, Seoul 138736, South Korea

[2] Univ Ulsan, Coll Med, Asan Med Ctr, Res Inst Radiol, 88 Olymp Ro,43 Gil, Seoul 138736, South Korea

[3] Univ Ulsan, Coll Med, Ctr Liver, Dept Gastroenterol,Asan Med Ctr, 88 Olymp Ro,43 Gil, Seoul 138736, South Korea

[4] Univ Ulsan, Coll Med, Asan Med Ctr, Dept Pathol, 88 Olymp Ro,43 Gil, Seoul 138736, South Korea

来源：

JOURNAL OF HEPATOLOGY | 2016年 / 64卷 / 05期

关键词：

Hepatocellular carcinoma; Magnetic resonance imaging; Gadoxetic acid; Diagnostic imaging; Diagnostic criteria; GD-EOB-DTPA; HEPATOBILIARY-PHASE; CIRRHOTIC LIVER; RADIOFREQUENCY ABLATION; BENIGN NODULES; MRI; TRANSPLANTATION; HYPOINTENSITY; SURVEILLANCE; PERFORMANCE;

D O I：

10.1016/j.jhep.2016.01.018

中图分类号：

R57 [消化系及腹部疾病];

学科分类号：

摘要：

Background & Aims: Current diagnostic imaging criteria for hepatocellular carcinoma (HCC) are dedicated to imaging with nonspecific extracellular contrast agents. This study aimed to evaluate diagnostic criteria for HCC cm on magnetic resonance imaging (MRI) with a hepatocyte-specific contrast agent through an inception cohort study. Methods: Of 291 patients with chronic liver disease and new nodules of 1-3 cm in diameter at surveillance ultrasonography, 295 solid nodules (194 HCCs, 98 benign nodules, and three other malignancies) in 198 patients with a confirmed final diagnosis or >= 24 months follow-up were evaluated on gadoxetic acid enhanced MRI. Through univariate and multivariate logistic regression analyses, various diagnostic criteria were developed by combining significant MRI findings for diagnosing HCC. The diagnostic performance of each criterion was compared with that of the European Association for the Study of the Liver (EASL) criteria. Results: Four MRI findings (arterial-phase hyperintensity, transitional-phase hypointensity, hepatobiliary-phase hypointensity, and rim enhancement) were independently significant for diagnosis of HCC <= 3 cm. For whole nodules, EASL criteria showed the best performance for diagnosing HCC (sensitivity, 83.5%; specificity, 81.2%). For nodules <= 2 cm in diameter, a new criterion (arterial-phase hyperintensity and hepatobiliary-phase hypointensity) showed a significantly higher sensitivity than that of the EASL criteria (83.0% vs. 74.5%, p = 0.008), without a significantly different specificity (76.7% vs. 81.1%, p = 0.125). Conclusions: EASL criteria exhibit the best diagnostic performance for HCC <= 3 cm on hepatocyte-specific contrast enhanced MRI. A newly identified criterion (arterial-phase hyper intensity and hepatobiliary-phase hypointensity) may increase the diagnostic sensitivity of small (<= 2 cm) HCC. (C) 2016 European Association for the Study of the Liver. Published by Elsevier B.V. All rights reserved.

引用

页码：1099 / 1107

页数：9

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