Central vascular structures as a characteristic finding of regenerative nodules using hepatobiliary phase gadolinium ethoxybenzyl diethylenetriaminepentaacetic acid-enhanced MRI and arterial dominant phase contrast-enhanced US.

Abstract

OBJECTIVE:

We investigated the characteristic findings of regenerative nodules (RNs) for differentiating early hepatocellular carcinoma (HCC) from high-grade dysplastic nodules (HGDNs) using magnetic resonance imaging (MRI) with gadolinium ethoxybenzyl diethylenetriaminepentaacetic acid (Gd-EOB-DTPA; EOB-MRI) and contrast-enhanced ultrasonography (CEUS) in patients with chronic liver disease.

SUBJECTS AND METHODS:

Pathologically confirmed lesions (100 early HCCs, 7 HGDNs, and 20 RNs with a maximum diameter of more than 1 cm and mean maximal diameters of 15.5, 15.1, and 14.8 mm, respectively) were enrolled in this retrospective study. The signal intensities of these lesions during the hepatobiliary phase of EOB-MRI were investigated, and findings characteristic of RNs using this modality were also evaluated using CEUS.

RESULTS:

Ninety-eight of the 100 early HCCs that were hypo-intense (n = 95), iso-intense (n = 2), or hyper-intense (n = 1) and the seven HGDNs that were hypo-intense (n = 6) or hyper-intense (n = 1) during the hepatobiliary phase of EOB-MRI exhibited centripetal vessels during the arterial dominant phase of CEUS, although one early HCC that was hypo-intense exhibited both centrifugal and centripetal vessels. Eighteen of the 20 RNs and one early HCC that were hyper-intense with a small central hypo-intensity and the remaining two RNs that were hyper-intense on EOB-MRI exhibited centrifugal vessels during the arterial dominant phase of CEUS. The small central hypo-intense area corresponded to central vascular structures in the lesion, such as the hepatic artery and portal vein running from the center to the periphery, when viewed using CEUS.

CONCLUSION:

Central vascular structures may be a characteristic finding of RNs when observed during the hepatobiliary phase of EOB-MRI and the arterial dominant phase of CEUS.

• Authors: Kazuya Sugimori, Kazushi Numata, Masahiro Okada, Hiromi Nihonmatsu, Shigeo Takebayashi, Shin Maeda, Masayuki Nakano, Katsuaki Tanaka
• Journal: Journal of medical ultrasonics (2001) (J Med Ultrason (2001)) Vol. 44 Issue 1 Pg. 89-100 (Jan 2017) ISSN: 1613-2254 [Electronic] Japan
• PMID: 27771842 (Publication Type: Journal Article)

Chemical References

• Contrast Media
• gadolinium ethoxybenzyl DTPA
• Gadolinium DTPA

Topics

• Adult
• Aged
• Aged, 80 and over
• Carcinoma, Hepatocellular (diagnostic imaging, pathology)
• Contrast Media
• Diagnosis, Differential
• Early Diagnosis
• Female
• Gadolinium DTPA
• Humans
• Liver (diagnostic imaging, pathology)
• Magnetic Resonance Imaging (methods)
• Male
• Middle Aged
• Retrospective Studies
• Ultrasonography (methods)