Gadoxetic Acid–Enhanced Hepatobiliary-Phase Magnetic Resonance Imaging for Delineation of Focal Nodular Hyperplasia: Superiority of High-Flip-Angle Imaging
Objective The aim of this study was to investigate whether hepatobiliary-phase (HBP) flip-angle (FA) increase to 25° improves conspicuity of focal nodular hyperplasia (FNH) and enables HBP delay reduction. Methods This was a retrospective study of 23 patients with 46 FNHs. In each patient, HBP was performed with reduced-delay high FA (early/high), standard-delay high FA (late/high), and standard-delay standard FA (standard). Relative enhancement of liver and FNH periphery, FNH periphery–to–liver contrast ratio, and FNH periphery–to–central scar contrast ratio were compared between each HBP. Results Early/high, late/high, and standard HBPs were performed after 13.00 ± 2.12, 19.12 ± 3.10, and 19.68 ± 3.22 minutes, respectively. Liver and FNH periphery relative enhancement, FNH periphery–to–liver contrast ratio, and FNH periphery–to–central scar contrast ratio were higher for early/high and late/high than for standard HBP (P
CONCLUSION: Liver nodules should be characterised with regard to underlying liver condition, MRI characteristics and contrast enhancement pattern, including hepatobiliary phase. In many cases, identification of fatty content may help narrowing the differential diagnosis. PMID: 32008550 [PubMed - in process]
ConclusionThe optimal visualization of FNH has been detected in early and middle arterial phases while HCC has been best observed during middle and late arterial phases.
Abstract PURPOSE: We aimed to qualitatively and quantitatively compare the enhancement pattern of focal nodular hyperplasia after gadobenate dimeglumine and gadoxetate disodium injection in the same patient. METHODS: 1.5 T magnetic resonance imaging (MRI) examinations of 16 patients with 21 focal nodular hyperplasias studied after the injection of both contrast media were evaluated. Both MRI studies were performed in all patients. A qualitative analysis was performed evaluating each lesion in all phases. For quantitative analysis we calculated signal intensity ratio, lesion-to-liver contrast ratio and liver p...
A 7-year-old patient with a stage 4 neuroblastoma underwent chemotherapy, surgery, myeloablative therapy, external beam radiotherapy, and Isoretinoin treatment. A posttreatment magnetic resonance examination performed administering gadoteric acid as contrast agent showed 2 new hypervascular hepatic lesions, suspicious for metastases. A second magnetic resonance imaging performed using a liver-specific contrast medium (gadolinium ethoxybenzyl diethylenetriamine pentaacetic acid) demonstrated that these lesions were consistent with treatment-related focal nodular hyperplasia.
Conclusion: The present study suggests that it is safe to conservatively manage patients with FNH presumed by highly accurate imaging tests. Similar to hepatic hemangiomas, surgery for FNH should be an exception.Dig Dis
This article reviews the pros and cons of HCC diagnosis with gadoxetic acid-enhanced MRI and discuss some clues in the radiological differentiation of HCC from HCC mimickers. PMID: 30661336 [PubMed - as supplied by publisher]
AbstractBackgroundFocal nodular hyperplasia and hepatic adenoma are rare liver tumors in which specific features on contrast-enhanced ultrasound (US) have been reported but are little known in children.ObjectiveTo assess the interobserver agreement in diagnosing and differentiating focal nodular hyperplasia and hepatic adenoma in children using established adult contrast-enhanced US characteristics.Materials and methodsThirty children with a definite or probable diagnosis of focal nodular hyperplasia or hepatic adenoma on magnetic resonance imaging (MRI)/histology who underwent contrast-enhanced US studies were included. T...
Journal of Magnetic Resonance Imaging, EarlyView.
Conclusions Laparoscopic liver biopsy has been widely used because of its safety and accuracy. It enables accurate resection of tumors that are undetectable with CT and US by employing preoperative 3D imaging while maintaining the less-invasiveness.
ConclusionAlthough PHL is a rare disease and biopsy is still required, an MRI could be indicative. In our series, PHL showed an insinuative growth, hypointense signal in the hepatobiliary phase, signal restriction in the DwI, and an ADC value lower than that of the other hepatic lesions analyzed.