Hypovascular Hepatic Nodules Showing Hypointense on the Hepatobiliary-Phase Image of Gd-EOB-DTPA-Enhanced MRI to Develop a Hypervascular Hepatocellular Carcinoma: A Nationwide Retrospective Study on Their Natural Course and Risk Factors
Hypovascular Hepatic Nodules Showing Hypointense on the Hepatobiliary-Phase Image of Gd-EOB-DTPA-Enhanced MRI to Develop a Hypervascular Hepatocellular Carcinoma: A Nationwide Retrospective Study on Their Natural Course and Risk Factors
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DOI：
10.1159/000355248
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发表时间：
2013-01-01
影响因子：
2.3
通讯作者：
Kudo, Masatoshi
中科院分区：
文献类型：
--
作者：
Inoue, Tatsuo;Hyodo, Tomoko;Kudo, Masatoshi
目的：我们的目的是通过在全国范围内进行一项回顾性纵向研究，调查在乙氧基苄基二乙烯三胺五乙酸钆（Gd-EOB-DTPA）增强MRI的肝胆期检测到的非富血管病变的自然结局。研究方法：在2008年2月至2011年3月期间，从参与本研究的机构招募了224名患者，共504个结节，通过成像诊断为非多血管。我们检查了非富血管病变的自然结果并评估了危险因素。结果：504个结节中，173个（34.3%）表现为富血供转化。12个月时多血管转化的总体累积发生率为14.9%，24个月时为45.8%。使用考克斯回归模型进行多变量分析，显示既往肝细胞癌治疗史（HCC;相对风险= 1.498; p = 0.036，95% CI 1.03-2.19）和T2加权图像上的高信号（相对危险度= 1.724; p = 0.015，95%CI 1.11-2.67）被确定为多血管转化的独立因素。结论：既往有HCC治疗史且T2加权图像上低信号结节显示高信号的患者需要仔细随访，因为高血管转化的发生率很高。(C)2013 S. Karger AG，巴塞尔
Objective: We aimed to investigate the natural outcome of nonhypervascular lesions detected in the hepatobiliary phase of gadolinium ethoxybenzyl diethylenetriamine pentaacetic acid (Gd-EOB-DTPA)-enhanced MRI by performing a longitudinal study retrospectively enrolled in a nationwide manner. Methods: Between February 2008 and March 2011, 224 patients with 504 nodules that were diagnosed as non-hypervascular by imaging were recruited from institutions that participated in the present study. We examined the natural outcome of nonhypervascular lesions and evaluated the risk factors. Results: Of the 504 nodules, 173 (34.3%) showed hypervascular transformation. The overall cumulative incidence of hypervascular transformation was 14.9% at 12 months and 45.8% at 24 months. Multivariate analysis using the Cox regression model revealed previous treatment history for hepatocellular carcinoma (HCC; relative risk = 1.498; p = 0.036, 95% CI 1.03-2.19) and hyperintensity on T2-weighted images (relative risk = 1.724; p = 0.015, 95% CI 1.11-2.67) were identified as independent factors for hypervascular transformation. Conclusions: Patients who have a previous treatment history for HCC and with hypointense nodules showing hyperintensity on T2-weighted images need careful follow-up because of the high incidence of hypervascular transformation. (C) 2013 S. Karger AG, Basel