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Japanese Journal of Radiology
Published in: Japanese Journal of Radiology 8/2018

01-08-2018 | Original Article

Differentiating malignant from benign hyperintense nodules on unenhanced T1-weighted images in patients with chronic liver disease: using gadoxetic acid-enhanced and diffusion-weighted MR imaging

Authors: Ji Yoon Moon, Seong Hyun Kim, Seo-Youn Choi, Jeong Ah Hwang, Ji Eun Lee, Jisun Lee

Published in: Japanese Journal of Radiology | Issue 8/2018

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Abstract

Purpose

To evaluate value of gadoxetic acid-enhanced and diffusion-weighted (DW) MRI for distinguishing malignant from benign hyperintense nodules on unenhanced T1-weighted images (T1WIs) in patients with chronic liver disease.

Materials and methods

Forty-two patients with 37 malignant and 41 benign hyperintense nodules on unenhanced T1WIs who underwent gadoxetic acid-enhanced and DW MRI, followed by histopathological examination, were included. Qualitative and quantitative analyses were conducted. Significant findings on univariate and multivariate analyses were identified and their diagnostic performances were analyzed for predicting hyperintense hepatocellular carcinomas (HCCs).

Results

In univariate analysis, hyperintensity on T2WI, arterial enhancement, washout, hypointensity on hepatobiliary phase, and diffusion restriction were more frequently observed (P < 0.05) in hyperintense HCCs. Tumor-to-liver SI ratio on hepatobiliary phase and minimum apparent diffusion coefficient (ADCmin) were significantly lower in hyperintense HCCs (P < 0.05). In multivariate analysis, hyperintensity on T2WI (OR, 13.58; P = 0.02), arterial enhancement (OR, 8.21; P = 0.002), and ADCmin ≤ 0.83 × 10−3 mm2/s (OR, 6.88; P = 0.008) were independently significant factors for predicting hyperintense HCCs. When two of three criteria were combined, 75.7% (28/37) of hyperintense HCCs were identified with a specificity of 92.7%, and when all three criteria were satisfied, the specificity was 97.6%.

Conclusion

Gadoxetic acid-enhanced and DW MRI may be helpful for differentiating malignant from benign hyperintense nodules on unenhanced T1WI.
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Metadata
Title
Differentiating malignant from benign hyperintense nodules on unenhanced T1-weighted images in patients with chronic liver disease: using gadoxetic acid-enhanced and diffusion-weighted MR imaging
Authors
Ji Yoon Moon
Seong Hyun Kim
Seo-Youn Choi
Jeong Ah Hwang
Ji Eun Lee
Jisun Lee
Publication date
01-08-2018
Publisher
Springer Japan
Published in
Japanese Journal of Radiology / Issue 8/2018
Print ISSN: 1867-1071
Electronic ISSN: 1867-108X
DOI
https://doi.org/10.1007/s11604-018-0748-x

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