Detection of Dysplastic Liver Nodules in Patients with Cirrhosis Using the Multi-Arterial CAIPIRINHA-Dixon-TWIST-Volume-Interpolated Breath-Hold Examination (MA-CDT-VIBE) Technique in Dynamic Contrast-Enhanced Magnetic Resonance Imaging.

BACKGROUND The multi-arterial CAIPIRINHA-Dixon-TWIST-volume-interpolated breath-hold examination (MA-CDT-VIBE) sequence has the advantage of detecting hypervascular lesions during the arterial phase of magnetic resonance imaging (MRI) of the liver. Liver cirrhosis may be associated with dysplastic nodules. This study aimed to compare the use of routine liver MRI sequences with the MA-CDT-VIBE sequence to identify dysplastic liver nodules in patients with liver cirrhosis. MATERIAL AND METHODS Between February 2016 and March 2017, there were 21 patients with liver cirrhosis who had 33 dysplastic liver nodules, which were detected by comprehensive multisequence MRI as the reference standard for nodule imaging. Liver MRI using edge sharpness assessment by parametric (ESAP) modeling was compared with five dynamic arterial subphases that were included in the MA-CDT-VIBE sequence with a temporal resolution of 2.8 s and an acquisition time of 20 s during one breath-hold. RESULTS In the 21 patients included in the study, the MA-CDT-VIBE technique (30/33 for the first reading and 33/33 for the second reading) showed an improved lesion detection rate compared with the ESAP technique (27/33 for the first reading and 29/33 for the second reading), and for 73% of the patients, MA-CDT-VIBE imaging showed improved arterial parenchyma contrast. There was a high degree of interobserver agreement between the two reads (kappa: 0.68-0.91; P<0.001). CONCLUSIONS The MA-CDT-VIBE sequence of MRI liver imaging improved the detection of dysplastic nodules in cirrhosis of the liver compared with routine liver MRI sequences.