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Small Nodule Detection in Cirrhotic Livers: Evaluation with US, Spiral CT, and MRI and Correlation with Pathologic Examination of Explanted Liver
- Source :
- Journal of Computer Assisted Tomography. 25:327-336
- Publication Year :
- 2001
- Publisher :
- Ovid Technologies (Wolters Kluwer Health), 2001.
-
Abstract
- Purpose The purpose of this work was to evaluate the detection and characterization of nodules > or = 8 mm and small hepatocellular carcinomas (HCCs) in liver cirrhosis. Method Pathologic examination and results of US, helical CT, and dynamic MRI with gadolinium were compared after orthotopic liver transplantation (OLT) of 43 cirrhotic patients. Nodules were classified as macroregenerative nodules (MRNs), borderline nodules (BNs), and HCC. Results Pathologic examination classified 69 nodules: 50 MRNs, 6 BNs, and 13 HCCs. Sensitivities of MRN, BN, and HCC detection were, respectively, for US imaging 2% (1/50), 33.3% (2/6), and 46.2% (6/13); for helical CT 2% (1/50), 50% (3/6), and 53.8% (7/13); and for MRI 42% (21/50), 50% (3/6), and 76.9% (10/13). MRI detected 21 MRNs. They presented on T1/T2-weighted images as hyperintense/hypointense (n = 8), hyperintense/isointense (n = 7), hypointense/hypointense (n = 4), hypointense/isointense (n = 1), and hypointense depicted only on echo planar imaging (n = 1). The three detected BNs were hyperintense/hypointense nodules. The 10 detected HCCs appeared hyperintense/isointense (n = 7), hyperintense/hypointense (n = 2), and hypointense/isointense (n = 1). None of the MRNs but eight HCCs and one BN were enhanced after gadolinium injection. Conclusion Contrast-enhanced MRI is the most sensitive technique for detecting liver nodules. No MR signal intensity pattern characteristic of small HCCs enables differentiation from benign nodules, however. Gadolinium enhancement is the most sensitive and specific characteristic of HCC.
- Subjects :
- Adult
Gadolinium DTPA
Liver Cirrhosis
Male
medicine.medical_specialty
Carcinoma, Hepatocellular
Cirrhosis
Gadolinium
medicine.medical_treatment
Contrast Media
chemistry.chemical_element
Liver transplantation
Sensitivity and Specificity
Carcinoma
Humans
Medicine
Radiology, Nuclear Medicine and imaging
Prospective Studies
Ultrasonography, Doppler, Color
Aged
Analysis of Variance
medicine.diagnostic_test
business.industry
Liver Neoplasms
Magnetic resonance imaging
Nodule (medicine)
Middle Aged
medicine.disease
Magnetic Resonance Imaging
digestive system diseases
Liver Transplantation
Liver
chemistry
Hepatocellular carcinoma
Dynamic contrast-enhanced MRI
Female
Radiology
medicine.symptom
Tomography, X-Ray Computed
business
Nuclear medicine
Subjects
Details
- ISSN :
- 03638715
- Volume :
- 25
- Database :
- OpenAIRE
- Journal :
- Journal of Computer Assisted Tomography
- Accession number :
- edsair.doi.dedup.....9a0471501c2ba643bf207eb37c6873d0
- Full Text :
- https://doi.org/10.1097/00004728-200105000-00001