Significance of hyperattenuating and contrast-enhancing hepatic nodules detected in the cirrhotic liver during arterial phase helical CT in pre–liver transplant patients: radiologic–histopathologic correlation of explanted livers |
| |
Authors: | P C Freeny M Grossholz K Kaakaji U P Schmiedl |
| |
Institution: | (1) Department of Radiology, Box 357115, University of Washington School of Medicine, 1959 Pacific Avenue, Seattle, WA 98195, USA, US |
| |
Abstract: | Background: Hyperattenuating nodules detected by arterial phase helical computed tomography (HCT) in patients with cirrhosis usually
are believed to represent hepatocellular carcinomas (HCCs). We correlated HCT morphology of hyperattenuating hepatic nodules
detected during arterial phase scans with the histopathology of explanted livers of patients with hepatic cirrhosis undergoing
liver transplantation.
Methods: Three hundred fifty-four patients had arterial and portal phase HCT performed before subsequent hepatic transplantation.
Each patient received 180 mL of contrast by power injection at 5 mL/s. All hyperattenuating nodules detected on arterial phase
HCT were assessed for morphology and evidence for contrast enhancement. Explanted livers in all patients were then sectioned
at 10-mm intervals, and the histology of the nodules was correlated with the HCT findings.
Results: Sixty-one hyperattenuating nodules were detected on the arterial phase HCT in 43 patients: 41 nodules were benign regenerating
nodules (RN), three were dysplastic nodules (DP), and 17 were HCCs. Most RN/DP nodules were 5–20 mm in diameter, had distinct
margins, were homogeneous, and were isoattenuating on precontrast, portal, and delayed scans. Thirty-six showed positive contrast
enhancement and displayed a wide range of attenuation profiles. HCC nodules were 6–50 mm. All showed positive contrast enhancement
and displayed a wide range of attenuation profiles.
Conclusion: Hyperattenuating nodules seen on arterial phase HCT are likely to be RN/DP nodules. In many cases, it is not possible to
distinguish between RN/DP and HCC. Thus, clinical decisions regarding inclusion criteria for transplantation based on CT morphology
of liver lesions may be tenuous. |
| |
Keywords: | : Computed tomography— Liver— Cirrhosis— Hepatocellular carcinoma— Regenerating nodules |
本文献已被 SpringerLink 等数据库收录! |
|