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Indeterminate Observations (Liver Imaging Reporting and Data System Category 3) on MRI in the Cirrhotic Liver: Fate and Clinical Implications

Authors
 Jin-Young Choi  ;  Hyun Cheol Cho  ;  Mark Sun  ;  Hyeon Chang Kim  ;  Claude B. Sirlin 
Citation
 AMERICAN JOURNAL OF ROENTGENOLOGY, Vol.201(5) : 993-1001, 2013 
Journal Title
 AMERICAN JOURNAL OF ROENTGENOLOGY 
ISSN
 0361-803X 
Issue Date
2013
MeSH
Adult ; Carcinoma, Hepatocellular/pathology ; Contrast Media ; Female ; Gadolinium DTPA ; Humans ; Image Enhancement/methods* ; Liver Cirrhosis/pathology* ; Liver Neoplasms/pathology ; Magnetic Resonance Imaging/methods* ; Male ; Middle Aged ; Radiology Information Systems ; Retrospective Studies
Keywords
cirrhosis ; hepatocellular carcinoma ; liver ; Liver Imaging Reporting and Data System ; MRI
Abstract
OBJECTIVE: The purpose of this article is to retrospectively evaluate the imaging characteristics and outcomes of indeterminate observations (Liver Imaging Reporting and Data System category 3) detected on MRI in patients with cirrhosis. MATERIALS AND METHODS: Sixty-nine indeterminate observations in 52 patients with cirrhosis were imaged with hepatobiliary contrast agent-enhanced MRI. Observations were evaluated retrospectively in terms of the location, size, enhancement pattern, and follow-up results. Each observation was categorized as stable or progressed observations according to serial follow-up MRI. RESULTS: The mean follow-up interval was 11.2 months. Forty-six (67%) of the total observations showed arterial enhancement, and 23 (33%) observations showed isointense signal or low signal intensity on arterial phase. The indeterminate observations were classified as arterial enhancement with fade-out appearance (41 observations [59%]), arterial enhancement with washout appearance (five observations [7%]), and nonhyperenhancing observations (23 observations [33%]). Two of 69 observations (3%) were hyperintense on T2-weighted images, and four of 55 observations (7%) were hyperintense on hepatocellular phase. On the final follow-up MRI examinations, four (6%) observations proved to be probable or definite hepatocellular carcinoma, 55 (80%) remained stable, and 10 (14%) decreased in size or were no longer visible. CONCLUSION: The most common cause of indeterminate observations on MRI is hypervascular pseudolesions that were clinically stable on follow-up imaging.
Full Text
http://www.ajronline.org/doi/abs/10.2214/AJR.12.10007
DOI
10.2214/AJR.12.10007
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Radiology (영상의학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Preventive Medicine and Public Health (예방의학교실) > 1. Journal Papers
Yonsei Authors
Kim, Hyeon Chang(김현창) ORCID logo https://orcid.org/0000-0001-7867-1240
Choi, Jin Young(최진영) ORCID logo https://orcid.org/0000-0002-9025-6274
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/88264
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