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Hypovascular hypointense nodules in hepatobiliary phase without T2 hyperintensity: long-term outcomes and added value of DWI in predicting hypervascular transformation

  • Hae Jin Yang
    Affiliations
    Department of Radiology, Chonbuk National University Medical School and Hospital, 20 Geonji-ro, Deokjin-gu, Jeonju, Chonbuk, 54907, Republic of Korea
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  • Ji Soo Song
    Correspondence
    Corresponding author at: Department of Radiology, Chonbuk National University Medical School and Hospital, Research Institute of Clinical Medicine of Chonbuk National University, Biomedical Research Institute of Chonbuk National University Hospital, 20 Geonji-ro, Deokjin-gu, Jeonju, Chonbuk, 54907, Republic of Korea.
    Affiliations
    Department of Radiology, Chonbuk National University Medical School and Hospital, 20 Geonji-ro, Deokjin-gu, Jeonju, Chonbuk, 54907, Republic of Korea

    Research Institute of Clinical Medicine of Chonbuk National University, 20 Geonji-ro, Deokjin-gu, Jeonju, Chonbuk, 54907, Republic of Korea

    Biomedical Research Institute of Chonbuk National University Hospital, 20 Geonji-ro, Deokjin-gu, Jeonju, Chonbuk, 54907, Republic of Korea
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  • Eun Jung Choi
    Affiliations
    Department of Radiology, Chonbuk National University Medical School and Hospital, 20 Geonji-ro, Deokjin-gu, Jeonju, Chonbuk, 54907, Republic of Korea

    Research Institute of Clinical Medicine of Chonbuk National University, 20 Geonji-ro, Deokjin-gu, Jeonju, Chonbuk, 54907, Republic of Korea

    Biomedical Research Institute of Chonbuk National University Hospital, 20 Geonji-ro, Deokjin-gu, Jeonju, Chonbuk, 54907, Republic of Korea
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  • HyeMi Choi
    Affiliations
    Department of Statistics, Chonbuk National University, 567 Baekje-daero, Deokjin-gu, Jeonju, Chonbuk, 54896, Republic of Korea
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  • Jae Do Yang
    Affiliations
    Department of Surgery, Chonbuk National University Medical School, 20 Geonji-ro, Deokjin-gu, Jeonju, Chonbuk, 54907, Republic of Korea
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  • Woo Sung Moon
    Affiliations
    Department of Pathology, Chonbuk National University Medical School, 20 Geonji-ro, Deokjin-gu, Jeonju, Chonbuk, 54907, Republic of Korea
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      Highlights

      • DWI hyperintensity is a significant predictive factor for hypervascularization.
      • Most nodular hypervascular transformations to HCC occurred within 3 years.
      • Careful follow-up is needed for nodules in patients with HCC risk factors.

      Abstract

      Purpose

      To evaluate outcomes and risk factors associated with hypervascularization in hypovascular, hepatobiliary phase (HBP) hypointense nodules (HHNs) without T2 hyperintensity on gadoxetic acid-enhanced magnetic resonance (MR) images in chronic liver disease patients.

      Materials and methods

      222 HHNs were analyzed. Multivariate analysis with a Cox proportional hazard regression model was used.

      Results

      41 nodules became hypervascular hepatocellular carcinoma (HCC). History of HCC, hyperintensity on T1WI or DWI, and higher growth rate were risk factors for hypervascularization (P < .05).

      Conclusion

      History of HCC, hyperintensity on T1WI or DWI, and higher growth rate were associated with nodular progression to hypervascular HCC.

      Abbreviations:

      OATP (organic anionic transporting polypeptides), HBP (hepatobiliary phase), DWI (diffusion weighted imaging), HHN (hypovascular HBP hypointense nodule), HCC (hepatocellular carcinoma), T1WI (T1 weighted images)

      Keywords

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