Gadoxetic acid enhanced MRI for differentiation of FNH and HCA: a single centre experience |
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Authors: | Christian Grieser Ingo G Steffen Incken-Birthe Kramme Hendrik Bläker Ergin Kilic Carmen Maria Perez Fernandez Daniel Seehofer Eckart Schott Bernd Hamm Timm Denecke |
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Institution: | 1. Klinik für Radiologie, Campus Virchow-Klinikum, Charité—Universit?tsmedizin Berlin, Augustenburger Platz 1, 13353, Berlin, Germany 2. Institut für Pathologie, Campus Virchow-Klinikum, Charité—Universit?tsmedizin Berlin, Berlin, Germany 3. Klinik für Allgemein, Viszeral- und Transplantationschirurgie, Campus Virchow-Klinikum, Charité—Universit?tsmedizin Berlin, Berlin, Germany 4. Medizinische Klinik m.S. Hepatologie und Gastroenterologie, Campus Virchow-Klinikum, Charité—Universit?tsmedizin Berlin, Berlin, Germany
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Abstract: | Objectives Evaluation of enhancement characteristics of histopathologically confirmed focal nodular hyperplasias (FNHs) and hepatocellular adenomas (HCAs) with gadoxetic acid-enhanced MRI. Methods Sixty-eight patients with 115 histopathologically proven lesions (FNHs, n?=?44; HCAs, n?=?71) examined with gadoxetic acid-enhanced MRI were retrospectively enrolled (standard of reference: surgical resection, n?=?53 patients (lesions: FNHs, n?=?37; HCAs, n?=?53); biopsy, n?=?15 (lesions: FNHs, n?=?7; HCAs, n?=?18)). Two radiologists evaluated all MR images regarding morphological features as well as the vascular and hepatocyte-specific enhancement in consensus. Results For the hepatobiliary phase, relative enhancement of the lesions and lesion to liver enhancement were significantly lower for HCAs (mean, 48.7 (±48.4) % and 49.4 (±33.9) %) compared to FNHs (159.3 (±92.5) %; and 151.7 (±79) %; accuracy of 89 % and 90 %, respectively; P?<?0.001). Visual strong uptake of FNHs vs. hypointensity of HCAs in the hepatobiliary phase resulted in an accuracy of 92 %. This parameter was superior to all other morphological and dynamic vascular criteria alone and in combination (accuracy, 54–85 %). Conclusions For differentiation of FNHs and HCAs by means of MRI, gadoxetic acid uptake in the hepatobiliary phase was found to be superior to all other criteria alone and in combination. Key Points ? EOB-MRI is well suited to differentiate FNHs and hepatocellular adenomas. ? For this purpose hepatobiliary phase is superior to unenhanced and dynamic imaging. ? Hepatobiliary phase (peripheral) hyper- or isointensity is typical for FNH. ? Hepatobiliary phase hypointensity is typical for hepatocellular adenomas. ? EOB-MRI helps to avoid misinterpretations of benign hepatocellular lesions. |
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