Department of Radiology, Kawasaki Medical School, 577 Matsushima, Kurashiki, Okayama, 701-0192, Japan.
AJR Am J Roentgenol. 2013 Jun;200(6):1254-60. doi: 10.2214/AJR.12.9136.
The purpose of our study was to evaluate the process and frequency of newly developed hypervascular hepatocellular carcinoma (HCC) in serial gadoxetic acid-enhanced MRI examinations in patients with chronic liver disease during clinical follow-up periods.
After review of 341 MRI examinations in 100 patients with chronic liver diseases who underwent gadoxetic acid-enhanced MRI at least twice during the observation period, 32 newly developed hypervascular HCCs in 14 patients were retrospectively evaluated. Serial MRI examinations before detecting hypervascular HCC were evaluated to determine whether hypervascular HCC showed the presence of a hypointense nodule on the hepatobiliary phase and hypovascularity (high-risk nodule) before hyper-vascularization. The size of newly developed hypervascular HCCs and the duration of hyper-vascularization from initial detection of a high-risk nodule were compared between HCCs with and without the presence of a high-risk nodule.
Eleven (34.4%) of 32 newly developed hypervascular HCCs had the presence of high-risk nodule before hypervascularization. The size of newly developed hypervascular HCCs was significantly smaller in HCC with high-risk nodule presence (mean, 9.5 mm) than in HCC without the presence of high-risk nodule (mean, 16.4 mm) (p = 0.004). In hypervascular HCCs with high-risk nodule presence, the mean duration of hypervascularization from initial high-risk nodule was 330.7 days, with mean size change from 5.4 mm of high-risk nodules to 9.5 mm of hypervascular HCCs.
Approximately one third of newly developed hypervascular HCCs had the presence of high-risk nodule before hypervascularization in the serial gadoxetic acid-enhanced MRI examinations. High-risk nodule tended to develop into hypervascular HCC after having almost doubled in size during 1 year of high-risk nodule presence.
本研究旨在评估慢性肝病患者临床随访期间连续钆塞酸增强 MRI 检查中新出现的富血管性肝细胞癌（HCC）的发生过程和频率。
对 100 例接受至少两次钆塞酸增强 MRI 检查的慢性肝病患者的 341 次 MRI 检查进行回顾性分析，其中 14 例患者共发现 32 个新出现的富血管性 HCC。对检测到富血管性 HCC 之前的连续 MRI 检查进行评估，以确定富血管性 HCC 是否在肝胆期显示出低信号结节的存在，以及在富血管化之前是否存在低血管性（高危结节）。比较有无高危结节的新发富血管性 HCC 的大小和从高危结节首次检测到富血管化的时间。
32 个新出现的富血管性 HCC 中有 11 个（34.4%）在富血管化之前存在高危结节。有高危结节存在的新发富血管性 HCC 的大小明显小于无高危结节存在的 HCC（分别为 9.5mm 和 16.4mm）（p=0.004）。在有高危结节存在的富血管性 HCC 中，从高危结节首次出现到富血管化的平均时间为 330.7 天，高危结节的平均大小变化从 5.4mm 增加到 9.5mm 的富血管性 HCC。
在连续的钆塞酸增强 MRI 检查中，大约三分之一的新发富血管性 HCC 在富血管化之前存在高危结节。高危结节在存在高危结节的 1 年内体积几乎增加一倍后，往往会发展成富血管性 HCC。
