Aims and objectives
Cirrhosis is a result of irreversible chronic liver damage characterized by fibrous septa and a nodular arrangement of the liver.
Nodules in cirrhosis can be present as regenerative,
sideroblastic or dysplastic and can lead to hepatocellular carcinoma (HCC) (1).
Dynamic contrast enhanced magnetic resonance imaging (MRI) is now widely used as a reference test for the noninvasive diagnosis of HCC,
and hyperenhancement in the arterial phase and washout in portal venous and/or late phases are characteristic for HCC according to the American Association for the...
Methods and materials
Materials and Methods
Patients
This retrospective study was approved by our Institutional Ethics Committee.
The radiology information system (RIS) of our institution was searched for patients for whom MRI reports included the keywords of cirrhosis,
chronic liver disease,
DN and HCC between August 2012 and September 2013.
Patients who received dynamic contrast enhanced abdominal MRI with a DW sequence,
age 18 years or older,
and having clinical and / or radiological signs of cirrhosis were enrolled in the study.
Serum AFP levels of patients enrolled...
Results
From the RIS,
72 patients met the inclusion criteria and were enrolled in the study.
Chronic liver disease was present in all patients.
Of the patients,
54 were male (75%) and 18 were female (25%).
A total of 82 nodules obtained from the patients were included in the study.
Of theses,
27 nodules were diagnosed as DN and 55 nodules accepted as HCC on the basis of dynamic multiphasic MRI criteria described by AASLD or histopathological findings.
Histopathological evaluation of surgical or tru-cut needle biopsy...
Conclusion
Dynamic contrast-enhanced MRI is now widely used as a reference test and has a role in the management of HCC according to the previously mentioned AASLD and EASL practice guidelines (2-4).
DW-MRI is a newly described imaging method and has a potential use in oncologic imaging.
In our study,
in addition to other studies,
we evaluated the use of DW-MRI in the differential diagnosis between DN and HCC nodules in patients with chronic liver disease and showed that high signal intensity on DW-MRI images,
low...
References
1.
Parente DB,
Perez RM,
Eiras-Araujo A,
Oliveira Neto JA,
Marchiori E,
Constantino CP,
Amorim VB,
Rodrigues RS.
MR imaging of hypervascular lesions in the cirrhotic liver: a diagnostic dilemma.
Radiographics 2012; 32(3): 767-787.
2.
Bruix J,
Sherman M.
Management of hepatocellular carcinoma: An update.
Hepatology 2011; 53(3): 1020–1022.
3.
Piana G,Trinquart L,Meskine N,Barrau V,Beers BV,Vilgrain V.NewMRimagingcriteriawith adiffusion-weightedsequencefor thediagnosisofhepatocellular carcinomainchronicliver diseases.J Hepatol 2011; 55(1): 126-132.
4. European Association for the Study of the Liver,
European Organisation for Research and Treatment of Cancer.
EASL–E ORTC clinical...