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- Title
MRI Using Gadoxetic Acid in the Work-Up of Liver Nodules Not Conclusively Benign in Budd-Chiari Syndrome: A Prospective Long-Term Follow-Up.
- Authors
García-Criado, Angeles; Rimola, Jordi; Seijo, Susana; Darnell, Anna; Belmonte, Ernest; Sapena, Victor; Moreno-Rojas, Julián; Pérez, Valeria; Hernández-Gea, Virginia; Ayuso, Carmen; Reig, Maria; García-Pagán, Juan Carlos; Bruix, Jordi
- Abstract
Introduction: The incidence of hepatocellular carcinoma (HCC) in Budd-Chiari syndrome (BCS) is unknown and there is no validated diagnostic work-up to define the liver nodules with arterial phase hyperenhancement (APHE), suggesting malignancy. This prospective study evaluates HCC incidence in a Western cohort of patients with BCS and assesses the performance of MRI with hepatobiliary contrast (HB-MRI) for nodule characterization. Methods: Patients with BCS followed in our hospital were prospectively evaluated by MRI with extracellular contrast (EC-MRI). Nodules with APHE categorized as non-conclusively benign by 2 radiologists were studied by HB-MRI and reviewed by 2 radiologists blinded to the EC-MRI results. A new EC-MRI 1 year later and clinical, analytical, and sonographic follow-up every 6 months for a median of 10 years was performed. Results: A total of 55 non-conclusively benign nodules with APHE were detected at EC-MRI in 41 patients. While 32 of them were suggestive of HCC by EC-MRI, all the 55 nodules showed increased uptake of hepatobiliary contrast. An unequivocal central scar was seen in 12/55 nodules at HB-MRI regardless of it was not detected on the EC-MRI. None of the nodules was hypointense in the hepatobiliary phase (HBP). HCC was not detected during a median of 10 years of follow-up. Conclusions: Detection of nodules with APHE is frequent in patients with BCS, but HCC is rare in Western patients with BCS. While EC-MRI may detect nodules suggesting malignancy, the identification of contrast uptake in the HBP at HB-MRI may help categorize them as benign.
- Subjects
BUDD-Chiari syndrome; MAGNETIC resonance imaging; LIVER; HEPATOCELLULAR carcinoma; HEPATIC veins
- Publication
Liver Cancer (2235-1795), 2024, Vol 13, Issue 2, p203
- ISSN
2235-1795
- Publication type
Article
- DOI
10.1159/000533598