• Young Kon Kim, Young Hwan Lee, Hyo Sung Kwak, Chong Soo Kim, and Young Min Han.
• Department of Diagnostic Radiology, Chonbuk National University Hospital and Medical School, Jeonbuk, South Korea. jmyr@dreamwiz.com
• Clin Imaging. 2008 Nov 1; 32 (6): 453-9.

ObjectiveThe purpose of this study is to determine the clinical implication of small (<20 mm) enhancing hepatic nodules observed only at three-dimensional gadobenate dimeglumine-enhanced hepatic arterial-phase magnetic resonance imaging (MRI) of the hepatitis B virus-induced mild cirrhosis.Materials And MethodsStudy population included 75 patients (58 men and 17 women; age range, 45-74 years) who had 100 arterial-only enhancing hepatic nodules occult during portal- and equilibrium-phase MRI. All patients had mild liver cirrhosis (Child class A, n=69; B, n=6) associated with viral hepatitis B. Two reviewers analyzed the MRIs in consensus regarding the size, shape, and signal intensity of nodules on the T1- and T2-weighted images.ResultsOf these 100 lesions, 78 and 22 proved to be hepatocellular carcinomas (HCCs) (size range, 0.6-1.9 cm; mean, 1.2 cm) and benign lesions (size range, 0.6-1.9 cm; mean, 1.0 cm), respectively. Most of the lesions (n=98) were oval or round shaped. Thirty-four HCCs were hypointense and/or hyperintense on the T1- and T2-weighted images, respectively. There was a trend toward an increased suspicion of HCC for arterial-only enhancing lesions occult on the portal- and equilibrium-phase and on T1- and T2-weighted MRI (n=44/66 for HCC vs. n=22/66 for benign lesions).ConclusionsSmall arterial-only enhancing nodules occult on the portal- and equilibrium-phase images as well as on the T1- and T2-weighted images are more likely to be HCC than nonneoplastic hypervascular benign lesions in patients with hepatitis B-induced mild cirrhosis.

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