Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea; Department of Radiology, Soonchunhyang University Cheonan Hospital, Cheonan, Korea.
Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
Eur J Radiol. 2017 Oct;95:362-369. doi: 10.1016/j.ejrad.2017.08.036. Epub 2017 Aug 31.
To assess the association between non-hypervascular hypointense nodules (NHHNs) on gadoxetic acid-enhanced magnetic resonance imaging (MRI) and liver stiffness (LS) in patients with chronic liver disease, and analyzed their progression to overt hepatocellular carcinoma (HCC).
Between August 2012 and March 2016, a total of 714 consecutive patients who had undergone transient elastography for LS measurement and gadoxetic acid-enhanced MRI were investigated. The association between the presence of NHHNs on the hepatobiliary phase and LS, and the patient's HCC status [none, presence of treatment-naïve HCC, or a history of previous HCC treatment] was assessed. In patients with these nodules, cumulative progression rates of nodules to overt HCC were compared with rates of new HCC development in other parts of the liver.
The prevalence of NHHNs was 16.8% (120/714). The presence of these nodules was significantly associated with the log LS (Odds ratio [OR], 1.48, p=0.002) and hepatitis B virus infection (OR, 3.14, p=0.017), regardless of the patient's HCC status. The two year cumulative progression rate of overt HCC from corresponding nodules and rate of progression to HCC in other parts of the liver were 34.1% and 18.3%, respectively (p=0.071).
The presence of NHHNs on gadoxetic acid-enhanced MRI was associated with higher LS and hepatitis B virus infection. Furthermore, these lesions frequently progressed to overt HCC.
评估慢性肝病患者钆塞酸增强磁共振成像（MRI）上非高血供低信号结节（NHHN）与肝硬度（LS）之间的相关性，并分析其向显性肝细胞癌（HCC）的进展情况。
2012 年 8 月至 2016 年 3 月，共对 714 例连续接受 LS 测量瞬态弹性成像和钆塞酸增强 MRI 的患者进行了研究。评估了肝胆期 NHHN 的存在与 LS 之间的相关性，以及患者的 HCC 状况[无、存在未经治疗的 HCC 或以前 HCC 治疗史]。在有这些结节的患者中，比较了结节向显性 HCC 的累积进展率与肝脏其他部位新发 HCC 的进展率。
NHHN 的患病率为 16.8%（120/714）。这些结节的存在与 LS 呈显著相关（优势比[OR]，1.48，p=0.002），与乙型肝炎病毒感染相关（OR，3.14，p=0.017），而与患者的 HCC 状况无关。来自相应结节的显性 HCC 的两年累积进展率和向肝脏其他部位进展的速率分别为 34.1%和 18.3%（p=0.071）。
钆塞酸增强 MRI 上 NHHN 的存在与较高的 LS 和乙型肝炎病毒感染相关。此外，这些病变常进展为显性 HCC。
