Gut Liver.  2018 Jan;12(1):79-85. 10.5009/gnl17046.

Non-hypervascular Hypointense Nodules on Hepatocyte Phase Gadoxetic Acid-Enhanced MR Images: Transformation of MR Hepatobiliary Hypointense Nodules into Hypervascular Hepatocellular Carcinomas

• Cho YK
• Kim JW
• Kim MY
• Cho HJ

• KMID: 2404721
• DOI: http://doi.org/10.5009/gnl17046

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.

Keyword

Liver neoplasms; Liver magnetic resonance; Carcinoma; hepatocellular; Malignant transformation

MeSH Terms

Carcinoma, Hepatocellular*
Follow-Up Studies
Hepatocytes*
Humans
Liver Neoplasms
Magnetic Resonance Imaging
Multivariate Analysis
Proportional Hazards Models
Retrospective Studies
Risk Factors