MR imaging features for improved diagnosis of hepatocellular carcinoma in the non-cirrhotic liver: Multi-center evaluation

作者：Fischer M A^*; Raptis D A; Donati O F; Hunziker R; Schade E; Sotiropoulos G C; McCall J; Bartlett A; Bachellier Ph; Frilling A; Breitenstein S; Clavien P A; Alkadhi H; Patak M

来源：European Journal of Radiology, 2015, 84(10): 1879-1887.

DOI：10.1016/j.ejard.2015.06.029

• Magnetic resonance imaging
• Liver neoplasms
• Carcinoma, hepatocellular
• Adenoma, liver cell, focal nodular
• hyperplasia

Purpose: To determine MR-imaging features for the differentiation between hepatocellular carcinoma (HCC) and benign hepatocellular tumors in the non-cirrhotic liver.
Material and Methods: 107 consecutive patients without liver cirrhosis (46 male; 45 +/- 14 years) who underwent liver resection due to suspicion of HCC were included in this multi-center study. The following imaging features were assessed: lesion diameter and demarcation, satellite-lesions, central-scar, capsule, fat-content, hemorrhage, vein-infiltration and signal-intensity (SI) on native T1-, T2- and dynamic-enhanced T1-weighted images (center versus periphery). In addition, contrast-media (CM) uptake in the liver specific phase was analyzed in a sub-group of 42 patients.
Results: Significant differences between HCC (n = 55) and benign lesions (n = 52) were shown for native T1-, T2- and dynamic-enhanced T1-SI, fat-content, and satellite-lesions (all, P < .05). Independent predictors for HCC were T1-hypointensity (odds-ratio, 4.81), T2-hypo-/hyperintensity (5.07), lack of central tumor-enhancement (3.36), and satellite-lesions (5.78; all P < 0.05). Sensitivity and specificity of HCC was 91% and 75% respectively for two out-of four independent predictors, whereas specificity reached 98% for all four predictors. Sub-analysis, showed significant differences in liver specific CM uptake between HCC (n = 18) and benign lesions (n = 24; P < 0.001) and revealed lack of liver specific CM uptake (odds-ratio, 2.7) as additional independent feature for diagnosis of HCC.
Conclusion: Independent MRI features indicating HCC are T1-hypointensity, T2-hypo- or hyperintensity, lack of central tumor-enhancement, presence of satellite-lesions and lack of liver specific CM-uptake. These features may have the potential to improve the diagnosis of HCC in the non-cirrhotic liver.

• 出版日期2015-10