کد مقاله | کد نشریه | سال انتشار | مقاله انگلیسی | نسخه تمام متن |
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6107228 | 1211171 | 2012 | 7 صفحه PDF | دانلود رایگان |
Background & AimsTo prospectively assess the diagnostic accuracy of the incorporation of additional magnetic resonance imaging (MRI) parameters in those based on contrast enhancement pattern for the diagnosis of solitary nodules between 5 and 20 mm, detected during surveillance in patients with cirrhosis.MethodsBetween November 2003 and January 2010, we prospectively included 159 cirrhotic patients with a newly detected solitary nodule between 5 and 20 mm in diameter by screening ultrasonography (US). Hepatic MRI and fine-needle biopsy were performed in all patients.ResultsFinal diagnoses were hepatocellular carcinoma (HCC) (n = 103), other malignant lesions (intrahepatic cholangiocarcinoma/metastases) (n = 4), and benign lesions (n = 52). The specific enhancement pattern (arterial enhancement followed by washout) yielded a sensitivity and specificity of 58.3% and 96.4%, respectively. Peritumoral capsule was present in 43 HCC and in 2 non-HCC lesions. Intralesional fat was detected in 24 nodules; 5 nodules were non-HCC. Finally, the presence of both capsule and fat was observed in 10 cases, all of them HCC (100% specificity), but all of them also displayed the specific enhancement pattern, thus adding no sensitivity or specificity.ConclusionsConclusive non-invasive diagnosis of HCC in cirrhosis should be based only on the contrast enhancement pattern, while other characteristics at MRI do not increase the diagnostic accuracy.
Journal: Journal of Hepatology - Volume 56, Issue 6, June 2012, Pages 1317-1323