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

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.

Keywords: Diffusion weighted image; Gadoxetic acid; Hepatocellular carcinoma; Hypervascular transformation; Magnetic resonance imaging.