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Large (>or 2 cm) non-hypervascular nodules depicted on MRI in the cirrhotic liver: fate and implications

Authors
 J.S. Yu  ;  J.J. Chung  ;  J.H. Kim  ;  K.W. Kim 
Citation
 CLINICAL RADIOLOGY, Vol.63(10) : 1121-1130, 2008 
Journal Title
CLINICAL RADIOLOGY
ISSN
 0009-9260 
Issue Date
2008
MeSH
Adult ; Female ; Follow-Up Studies ; Hepatitis B, Chronic/complications ; Humans ; Liver Cirrhosis/complications* ; Liver Cirrhosis/virology ; Liver Cirrhosis, Alcoholic/complications ; Liver Neoplasms/diagnosis ; Liver Neoplasms/etiology* ; Liver Neoplasms/pathology ; Magnetic Resonance Imaging/methods ; Male ; Middle Aged ; Precancerous Conditions/diagnosis ; Precancerous Conditions/etiology ; Precancerous Conditions/pathology ; Prognosis ; Retrospective Studies
Keywords
Adult ; Female ; Follow-Up Studies ; Hepatitis B, Chronic/complications ; Humans ; Liver Cirrhosis/complications* ; Liver Cirrhosis/virology ; Liver Cirrhosis, Alcoholic/complications ; Liver Neoplasms/diagnosis ; Liver Neoplasms/etiology* ; Liver Neoplasms/pathology ; Magnetic Resonance Imaging/methods ; Male ; Middle Aged ; Precancerous Conditions/diagnosis ; Precancerous Conditions/etiology ; Precancerous Conditions/pathology ; Prognosis ; Retrospective Studies
Abstract
AIM: To determine the fate and clinical implication of large (>or=2 cm), non-hypervascular nodules depicted on magnetic resonance imaging (MRI) in the cirrhotic liver.

MATERIALS AND METHODS: In 21 patients with cirrhosis (14 hepatitis B, two ethanol abuse, four cryptogenic, one Wilson's disease), 25 large (>or=2 cm in the longest dimension) non-hypervascular nodules were identified on dynamic MRI. The implications for diagnosis of the initial size, contour, and signal characteristics on MRI in addition to patients' age and cause of cirrhosis were assessed in our analysis.

RESULTS: Twelve (75%) out of 16 lesions were malignant or potentially-malignant from 14 hepatitis B patients, while seven (78%) of the nine lesions from other patients were benign (p=0.016). The mean age of the patients who had malignant or potentially malignant lesions (57 years) was older than that for the other patients (47 years; p=0.039). The ratio of the short-to-long diameter was higher in malignant or potentially malignant lesions (mean 0.86) than in benign lesions (mean 0.69; p=0.008). There was no discriminative signal intensity characteristic (p>0.2 for all factors) that indicated the malignant potential for each non-hypervascular nodule. For all 10 lesions in the hepatitis B patients who were older than 52 years with a short-to-long diameter ratio of more than 0.75, the positive predictive value for malignant potential based on these three combined factors was 100%.

CONCLUSION: In older patients with cirrhosis from hepatitis B, large (>or=2 cm), non-hypervascular nodules with a spherical contour have a high malignant potential.
Full Text
http://www.sciencedirect.com/science/article/pii/S0009926008001608
DOI
10.1016/j.crad.2008.03.005
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Radiology (영상의학교실) > 1. Journal Papers
Yonsei Authors
Kim, Ki Whang(김기황)
Kim, Joo Hee(김주희) ORCID logo https://orcid.org/0000-0001-5383-3602
Yu, Jeong Sik(유정식) ORCID logo https://orcid.org/0000-0002-8171-5838
Chung, Jae Joon(정재준) ORCID logo https://orcid.org/0000-0002-7447-1193
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/107011
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