Non-invasive diagnosis of hepatocellular carcinoma %26lt;= 2 cm in cirrhosis. Diagnostic accuracy assessing fat, capsule and signal intensity at dynamic MRI

作者：Rimola Jordi^*; Forner Alejandro; Tremosini Silvia; Reig Maria; Vilana Ramon; Bianchi Luis; Rodriguez Lope Carlos; Sole Manel; Ayuso Carmen; Bruix Jordi

来源：Journal of Hepatology, 2012, 56(6): 1317-1323.

DOI：10.1016/j.jhep.2012.01.004

• Hepatocellular carcinoma
• Magnetic resonance
• Cirrhosis
• Dynamic imaging
• Diagnosis

Background %26 Aims: To prospectively assess the diagnostic accuracy of the incorporation of additional magnetic resonance imaging (MRI) parameters in those based on contrast enhancement pattern for the diagnosis of solitary nodules between 5 and 20 mm, detected during surveillance in patients with cirrhosis. %26lt;br%26gt;Methods: Between November 2003 and January 2010, we prospectively included 159 cirrhotic patients with a newly detected solitary nodule between 5 and 20 mm in diameter by screening ultrasonography (US). Hepatic MRI and fine-needle biopsy were performed in all patients. %26lt;br%26gt;Results: Final diagnoses were hepatocellular carcinoma (HCC) (n = 103), other malignant lesions (intrahepatic cholangiocarcinoma/metastases) (n = 4), and benign lesions (n = 52). The specific enhancement pattern (arterial enhancement followed by washout) yielded a sensitivity and specificity of 58.3% and 96.4%, respectively. Peritumoral capsule was present in 43 HCC and in 2 non-HCC lesions. Intralesional fat was detected in 24 nodules; 5 nodules were non-HCC. Finally, the presence of both capsule and fat was observed in 10 cases, all of them HCC (100% specificity), but all of them also displayed the specific enhancement pattern, thus adding no sensitivity or specificity. %26lt;br%26gt;Conclusions: Conclusive non-invasive diagnosis of HCC in cirrhosis should be based only on the contrast enhancement pattern, while other characteristics at MRI do not increase the diagnostic accuracy.

• 出版日期2012-6