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Bouyer T, Roux M, Jacquemin S, Dioguardi Burgio M, Sutter O, Laurent-Croisé V, Lonjon J, Bricault I, Trillaud H, Rode A, Aubé C, Paisant A. Detection of arterial phase hyperenhancement of small hepatocellular carcinoma with MRI: Comparison between single arterial and multi-arterial phases and between extracellular and hepatospecific contrast agents. Diagn Interv Imaging 2023; 104:477-484. [PMID: 37211446 DOI: 10.1016/j.diii.2023.04.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2023] [Revised: 03/21/2023] [Accepted: 04/21/2023] [Indexed: 05/23/2023]
Abstract
PURPOSE The purpose of this study was to compare the detection rate of arterial phase hyperenhancement (APHE) in small hepatocellular carcinoma (HCC) between single arterial phase (single-AP) and triple hepatic arterial (triple-AP) phase MRI and between extracellular (ECA) and hepato-specific (HBA) contrast agents. MATERIALS AND METHODS A total of 109 cirrhotic patients with 136 HCCs from seven centers were included. There were 93 men and 16 women, with a mean age of 64.0 ± 8.9 (standard deviation) years (range: 42-82 years). Each patient underwent both ECA-MRI and HBA (gadoxetic acid)-MRI examination within one month of each other. Each MRI examination was retrospectively reviewed by two readers blinded to the second MRI examination. The sensitivities of triple- and single-AP for the detection of APHE were compared, and each phase of the triple-AP sequence was compared with the other two. RESULTS No differences in APHE detection were found between single-AP (97.2%; 69/71) and triple-AP (98.5%; 64/65) (P > 0.99) at ECA-MRI. No differences in APHE detection were found between single-AP (93%; 66/71) and triple-AP (100%; 65/65) at HBA-MRI (P = 0.12). Patient age, size of the nodules, use of automatic triggering, type of contrast agent, and type of sequence were not significantly associated with APHE detection. The reader was the single variable significantly associated with APHE detection. For triple-AP, best APHE detection rate was found for early and middle-AP images compared to late-AP images (P = 0.001 and P = 0.003). All APHEs were detected with the combination of early-AP and middle-AP images, except one that was detected on late-AP images by one reader. CONCLUSION Our study suggests that both single- and triple-AP can be used in liver MRI for the detection of small HCC especially when using ECA. Early AP and middle-AP are the most efficient phases and should be preferred for detecting APHE, regardless of the contrast agent used.
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Affiliation(s)
- Thomas Bouyer
- Department of Radiology, Centre Hospitalier Universitaire d'Angers, 49933 Angers, France.
| | - Marine Roux
- Laboratoire HIFIH, UPRES 3859, SFR 4208, Université d'Angers, 49045 Angers, France
| | - Sarah Jacquemin
- Department of Radiology, Centre Hospitalier Universitaire d'Angers, 49933 Angers, France
| | - Marco Dioguardi Burgio
- Department of Radiology, Hôpital Beaujon, APHP Nord, 92110 Clichy, France; Université de Paris, Centre de recherche sur l'inflammation, INSERM, U1149, CNRS, ERL8252, Paris, 75018, France
| | - Olivier Sutter
- Department of Radiology, Hôpital Jean Verdier, Hôpitaux Universitaires Paris-Seine-Saint-Denis (AP-HP), 93140 Bondy, France
| | - Valérie Laurent-Croisé
- Department of Radiology, Centre Hospitalier Universitaire de Nancy, Hôpital de Brabois, 54500 Vandœuvre-lès-Nancy, France
| | - Julie Lonjon
- Department of Radiology, Centre Hospitalier Universitaire Saint Eloi, 34090 Montpellier, France
| | - Ivan Bricault
- Université Grenoble Alpes, CNRS, 38400 Grenoble, France; Department of Radiology, Centre Hospitalier Universitaire Grenoble Alpes, 38700 Grenoble, France
| | - Hervé Trillaud
- Department of Radiology, Centre Hospitalier Universitaire de Bordeaux, 33000 Bordeaux, France
| | - Agnès Rode
- Department of Radiology, Hôpital de la Croix Rousse, Hospices Civils de Lyon, Centre Hospitalier Universitaire, 69317 Lyon Cedex 04, France
| | - Christophe Aubé
- Department of Radiology, Centre Hospitalier Universitaire d'Angers, 49933 Angers, France; Laboratoire HIFIH, UPRES 3859, SFR 4208, Université d'Angers, 49045 Angers, France
| | - Anita Paisant
- Department of Radiology, Centre Hospitalier Universitaire d'Angers, 49933 Angers, France; Laboratoire HIFIH, UPRES 3859, SFR 4208, Université d'Angers, 49045 Angers, France
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MR imaging features and long-term evolution of benign focal liver lesions in Budd-Chiari syndrome and Fontan-associated liver disease. Diagn Interv Imaging 2021; 103:111-120. [PMID: 34654671 DOI: 10.1016/j.diii.2021.09.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2021] [Revised: 09/06/2021] [Accepted: 09/08/2021] [Indexed: 02/08/2023]
Abstract
PURPOSE To compare the magnetic resonance imaging (MRI) features of benign liver lesions developed on Budd-Chiari syndrome (BCS) with those on Fontan-associated liver disease (FALD) and to describe their long-term progression. MATERIALS AND METHODS Patients with BCS or FALD who underwent MRI between 2010 and 2020 were retrospectively included. MRI features of nodules (≥ 5 mm) at baseline and at final follow-up were reviewed. The final diagnosis of benign lesion was based on a combination of clinical and biological data and findings at follow-up MRI examination. RESULTS Two-hundred and thirty benign liver lesions in 39 patients with BCS (10 men, 29 women; mean age, 36 ± 11 [SD] years; age range: 15-66 years) and 84 benign lesions in 14 patients with FALD (2 men, 12 women; mean age, 31 ± 10 [SD] years; age range: 20-48 years) were evaluated. On baseline MRI, BCS nodules were more frequently hyperintense on T1-weighted (183/230, 80%) and hypointense on T2-weighted (142/230; 62%) images, while FALD nodules were usually isointense on both T1- (70/84; 83%) and T2-weighted (64/84; 76%) images (all P< 0.01). Most lesions showed arterial phase hyperenhancement (222/230 [97%] vs. 80/84 [95%] in BCS and FALD, respectively; P = 0.28) but wash-out was more common in BCS (64/230 [28%] vs. 9/84 [11%]; P < 0.01). At follow-up, changes were more frequent in BCS nodules with more frequent disappearance (P < 0.01), changes in size, signal intensity on T2-weighted, portal, and delayed phase, and in the depiction of washout and capsule (all P ≤ 0.03). CONCLUSION MRI features of benign lesions are different at diagnosis and during the course of the disease between BCS and FALD. Changes in size and MRI features are more frequent in benign lesions developed in BCS.
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