Doughnut-like hyperintense nodules on hepatobiliary phase without arterial-phase hyperenhancement in cirrhotic liver: imaging and clinicopathological features.
Objectives: To determine the imaging and clinicopathological features of MRI doughnut-like nodules (HBP-doughnut nodules), hyperintense at the hepatobiliary phase (HBP) after injection of gadoxetic acid (EOB) and without arterial-phase hyperenhancement (APHE) in cirrhotic liver.Methods: The Institut...
| Published in: | European Radiology Vol. 29; no. 12; pp. 6489 - 6499 |
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| Main Authors: | , , , , , , , , , , |
| Format: | diagnostic images pictorial research tables/charts Journal Article |
| Published: |
Springer Nature
Dec2019
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| Online Access: | View this record in EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=139479407&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 139479407 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 09387994 NPH jtl: European Radiology issn: 09387994 maglogo: N pubinfo: dt: Dec2019 vid: 29 iid: 12 pid: 237 pub: Springer Nature place: New York, New York artinfo: ui: 139479407 139479407 NLM31278576 139479407 10.1007/s00330-019-06329-y NLM31278576 139479407 ppf: 6489 ppct: 10 formats: fmt: – @attributes: type: T – @attributes: type: P tig: atl: Doughnut-like hyperintense nodules on hepatobiliary phase without arterial-phase hyperenhancement in cirrhotic liver: imaging and clinicopathological features. aug: au: Kozaka, Kazuto Kobayashi, Satoshi Yoneda, Norihide Kitao, Azusa Yoshida, Kotaro Inoue, Dai Ogi, Takahiro Koda, Wataru Sato, Yasunori Gabata, Toshifumi Matsui, Osamu affil: Department of Radiology, Kanazawa University Graduate School of Medical Sciences, 13-1 Takara-machi, 920-8640, Kanazawa, Japan sug: subj: Liver Cirrhosis Liver Neoplasms Magnetic Resonance Imaging Methods Liver Cirrhosis Complications Liver Neoplasms Complications Liver Cirrhosis Pathology Image Enhancement Methods Middle Age Contrast Media Aged Female Retrospective Design Liver Liver Pathology Liver Neoplasms Pathology Male Human Middle Aged: 45-64 years Aged: 65+ years Female Male ab: Objectives: To determine the imaging and clinicopathological features of MRI doughnut-like nodules (HBP-doughnut nodules), hyperintense at the hepatobiliary phase (HBP) after injection of gadoxetic acid (EOB) and without arterial-phase hyperenhancement (APHE) in cirrhotic liver.Methods: The Institutional Review Board approved this retrospective study and informed consent was waived. We enrolled 309 consecutive patients with liver cirrhosis who were examined by EOB-MRI, dynamic CT, and angiography-assisted CT between 2008 and 2012 and searched for HBP-doughnut nodules. We evaluated imaging characteristics including haemodynamics and signal intensity of MRI, pathological findings, and frequency of malignant transformation.Results: One hundred and one HBP-doughnut nodules without APHE were identified in 18 patients (6%), including seven of 59 (12%) patients with hepatitis-B-virus-related, nine of 230 (3.9%) with hepatitis-C-virus-related, and two of 33 (6.1%) with alcoholic cirrhosis. All nodules showed enhancement peaks in the portal phase, the same or increased intranodular portal supply on CT during arterial portography, and the same or decreased intranodular arterial supply on CT during hepatic arteriography. On T2-weighted and diffusion-weighted images, 37 (36%) and 24 (24%) nodules, respectively, showed hyperintensity predominantly in the central area. Three nodules were diagnosed by fine needle biopsy as non-neoplastic hepatic nodules. Ninety-three of 101 (92%) nodules in 16 patients were followed up during an observation period of 1163 ± 902 days (range 57-2920 days), and none showed malignant transformation.Conclusion: HBP-doughnut nodules without APHE in cirrhotic liver were not infrequent. None became malignant. We propose calling them 'multiacinar cirrhotic nodules' based on the classification by an International Working Party.Key Points: • HBP-doughnut nodules without APHE were seen in 6% of patients with liver cirrhosis. • The enhancement peak of HBP-doughnut nodules without APHE was in the portal phase, which reflected the fact that they were supplied predominantly by the portal vein, based on angiography-assisted CT findings. • None of the HBP-doughnut nodules without APHE in cirrhotic liver became malignant, and in conjunction with limited pathological features, they may be corresponding to multiacinar cirrhotic nodules in the International Working Party classification. pubtype: Academic Journal doctype: diagnostic images pictorial research tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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