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Keywords:
Neoplasia, Cirrhosis, Cancer, Diagnostic procedure, Computer Applications-Detection, diagnosis, Acceptance testing, PACS, MR-Diffusion/Perfusion, MR, Oncology, Liver, Abdomen
Authors:
V. Karagöz, A. Aslan, M. Acar; Istanbul/TR
DOI:
10.1594/ecr2015/C-2092
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 Study of Liver Diseases (AASLD) and the European Association for the Study of the Liver (EASL) guidelines,
with no need of biopsy (2-4).
Diffusion-weighted MRI (DW-MRI) has gained attention and can provide qualitative (signal intensity) and quantitative (apparent diffusion coefficient) data about liver masses to differentiate malignant from benign masses (3,
5,
6).
DW-MRI can provide information about histological differences related to diseases (7).
As the benign cirrhotic liver nodules differentiate and progress to HCC,
extracellular space is narrowed and the number of cells is increased.
Therefore,
movement of water molecules is restricted and the diffusivity of water molecules is decreased (5,
8).
There are many studies regarding DW-MRI for differentiating benign and malignant liver masses,
but only a small number of them concern the DW-MRI findings of DN and HCC nodules in chronic liver disease.
In this study we aimed to propose the contribution of DW-MRI for the differentiation of DN and HCC nodules in cirrhotic liver and to investigate the correlation of ADC values with serum alpha-fetoprotein (AFP) levels and the size of HCC nodules.