Was Hypervascular Hepatocellular Carcinoma Visible on Previous Gadoxetic Acid-Enhanced Magnetic Resonance Images?
Was Hypervascular Hepatocellular Carcinoma Visible on Previous Gadoxetic Acid-Enhanced Magnetic Resonance Images?
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DOI：
10.1159/000367736
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发表时间：
2015-01-01
期刊：
影响因子：
13.8
通讯作者：
Fujii, Hideki
中科院分区：
文献类型：
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作者：
Ichikawa, Shintaro;Ichikawa, Tomoaki;Fujii, Hideki
背景资料：在慢性肝病患者的随访过程中，富血管性肝细胞癌（HCC）可以从预先存在的高风险结节或从头肝癌发生发展。本研究的目的是通过回顾性分析，评价既往肝细胞期乙氧基苄基二亚乙基三胺五乙酸钆增强磁共振成像（EOB-MRI）对当前EOB-MRI最初检测到的富血供HCC的可检测性和信号强度。研究方法：我们检查了39例患者中的50例最初检测到的富血供HCC，这些患者的EOB-MRI显示了典型的增强特征，这些患者的既往EOB-MRI图像在6-19个月前获得。评估了之前EOB-MRI肝细胞相位图像上每种富血管性肝癌的可检测性。在当前EOB-MRI图像上发现多血管HCC的位置，既往EOB-MRI肝细胞期图像的成像特征被分类为可检测或不可检测。将既往EOB-MRI肝细胞期图像上可检测到的结节（定义为A组）的信号强度分为低、等或高信号。将既往EOB-MRI肝细胞期图像上未检测到的结节分配至B组。结果：22例（22/50，44%）多血管肝癌在早期肝细胞期图像上可检出（A组）。相比之下，28例（28/50，56%）多血管HCC在早期EOB-MRI图像的肝细胞期未检测到（B组）。结论：当以前的EOB-MRI图像被用作参考，超过一半（28/50，56%）的富血管HCC最初出现在当前的EOB-MRI图像被发现没有发展从结节检测以前的MRI通过传统上接受的多步骤癌变过程。相反，它们似乎是通过慢性肝病患者的“影像隐匿”致癌过程发展起来的。版权所有（C）2015 S. Karger AG，巴塞尔
Background: During the follow-up of patients with chronic liver disease, hypervascular hepatocellular carcinomas (HCCs) can develop either from pre-existing high-risk nodules or by de novo hepatocarcinogenesis. The purpose of this study was to evaluate, by retrospective analysis, the detectability and signal intensity on previous hepatocyte-phase gadolinium ethoxybenzyl diethylenetriamine pentaacetic acid-enhanced magnetic resonance imaging (EOB-MRI) of hypervascular HCC initially detected on current EOB-MRIs. Methods: We examined 50 initially detected hypervascular HCCs that showed typical enhancement features on EOB-MRI in 39 patients whose previous EOB-MRI images obtained 6-19 months earlier were available. The detectability of each hypervascular HCC on the hepatocyte phase images of previous EOB-MRIs was assessed. The imaging features on hepatocyte-phase images of previous EOB-MRIs at the locations where hypervascular HCCs were found on the current EOB-MRI images were classified as detectable or undetectable. The signal intensities of detectable nodules (defined as group A) on hepatocyte-phase images of previous EOB-MRIs were classified as hypo-, iso-, or hyperintensity. Nodules undetectable on the hepatocyte-phase images of previous EOB-MRIs were assigned to group B. Results: Twenty-two (22/50, 44%) hypervascular HCCs were detectable on the earlier hepatocyte phase images (group A). In contrast, 28 (28/50, 56%) hypervascular HCCs were not detectable on the hepatocyte phase of earlier EOB-MRI images (group B). Conclusion: When the previous EOB-MRI images were used as the reference, more than half (28/50, 56%) of hypervascular HCCs initially appearing on the current EOB-MRI images were found not to have developed from nodules detectable on the previous MRIs through the traditionally accepted process of multistep carcinogenesis. Instead, they seemed to have developed via an "imaging-occult" process of carcinogenesis in patients with chronic liver diseases. Copyright (C) 2015 S. Karger AG, Basel