Hepatobiliary MR contrast agents are useful to diagnose hepatocellular carcinoma in patients with Budd-Chiari syndrome.

AFP, alpha-fetoprotein APHE, arterial phase hyperenhancement BCS, Budd-Chiari syndrome FNH, focal nodular hyperplasia-like HBP, hepatobiliary phase HCC HCC, hepatocellular carcinoma Imaging LR, likelihood ratio MRI OATP, organic anionic transporting polypeptides T1-w, T1-weighted imaging TIPS, transjugular intrahepatic portosystemic shunt WO, washout liver cancer non-invasive tumor vascular liver disease

Journal

JHEP reports : innovation in hepatology
ISSN: 2589-5559
Titre abrégé: JHEP Rep
Pays: Netherlands
ID NLM: 101761237

Informations de publication

Date de publication:
Jun 2020
Historique:
received: 11 02 2020
accepted: 24 02 2020
entrez: 22 5 2020
pubmed: 22 5 2020
medline: 22 5 2020
Statut: epublish

Résumé

Hepatobiliary phase (HBP) images can discriminate between benign and malignant liver lesions, but it is unclear if this approach can be used in patients with Budd-Chiari syndrome (BCS). Thus, we aimed to assess the diagnostic utility of HBP images in patients with BCS. This retrospective study included all patients admitted to our institution with a diagnosis of BCS and focal liver lesions on hepatobiliary contrast agent-enhanced MR imaging (HBCA-MRI) from 2000 to 2019. MR images were reviewed by 2 radiologists blinded to the diagnosis of the lesions. Patient and lesion characteristics were recorded, focusing on HBP imaging features. Twenty-six patients (mean 35 ± 11 years old [13-65]; 21 women [81%] 35 ± 12 years old [13-65]; 5 men [19%] 36 ± 10 years old [19-44]) with 99 benign liver lesions and 12 hepatocellular carcinomas (HCCs) were analyzed. Patients with HCC were significantly older than those with benign lesions (mean 50 ± 10 Most benign lesions showed homogeneous or peripheral hyperintensity on HBP images while all HCCs were homogeneously hypointense. HBP images are helpful to differentiate between benign lesions and HCCs and outperform other sequences. They should be systematically acquired for the characterization of focal lesions in patients with BCS. Hepatobiliary phase imaging is an approach that has recently been shown to discriminate between benign and malignant lesions in the liver. However, it was not known whether this imaging approach could be used effectively in patients with Budd-Chiari syndrome. Herein, we have shown that hepatobiliary phase imaging appears to be useful for differentiating between benign and malignant liver lesions in patients with Budd-Chiari syndrome.

Sections du résumé

BACKGROUND & AIMS OBJECTIVE
Hepatobiliary phase (HBP) images can discriminate between benign and malignant liver lesions, but it is unclear if this approach can be used in patients with Budd-Chiari syndrome (BCS). Thus, we aimed to assess the diagnostic utility of HBP images in patients with BCS.
METHODS METHODS
This retrospective study included all patients admitted to our institution with a diagnosis of BCS and focal liver lesions on hepatobiliary contrast agent-enhanced MR imaging (HBCA-MRI) from 2000 to 2019. MR images were reviewed by 2 radiologists blinded to the diagnosis of the lesions. Patient and lesion characteristics were recorded, focusing on HBP imaging features.
RESULTS RESULTS
Twenty-six patients (mean 35 ± 11 years old [13-65]; 21 women [81%] 35 ± 12 years old [13-65]; 5 men [19%] 36 ± 10 years old [19-44]) with 99 benign liver lesions and 12 hepatocellular carcinomas (HCCs) were analyzed. Patients with HCC were significantly older than those with benign lesions (mean 50 ± 10
CONCLUSION CONCLUSIONS
Most benign lesions showed homogeneous or peripheral hyperintensity on HBP images while all HCCs were homogeneously hypointense. HBP images are helpful to differentiate between benign lesions and HCCs and outperform other sequences. They should be systematically acquired for the characterization of focal lesions in patients with BCS.
LAY SUMMARY BACKGROUND
Hepatobiliary phase imaging is an approach that has recently been shown to discriminate between benign and malignant lesions in the liver. However, it was not known whether this imaging approach could be used effectively in patients with Budd-Chiari syndrome. Herein, we have shown that hepatobiliary phase imaging appears to be useful for differentiating between benign and malignant liver lesions in patients with Budd-Chiari syndrome.

Identifiants

pubmed: 32435753
doi: 10.1016/j.jhepr.2020.100097
pii: S2589-5559(20)30031-8
pii: 100097
pmc: PMC7232085
doi:

Types de publication

Journal Article

Langues

eng

Pagination

100097

Informations de copyright

© 2020 The Author(s).

Déclaration de conflit d'intérêts

The authors declare no conflicts of interest that pertain to this work. Please refer to the accompanying ICMJE disclosure forms for further details.

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Auteurs

Morgane Van Wettere (M)

Department of Radiology, APHP, University Hospitals Paris Nord Val de Seine, Beaujon, Clichy, France.

Luisa Paulatto (L)

Department of Radiology, APHP, University Hospitals Paris Nord Val de Seine, Beaujon, Clichy, France.

Lucas Raynaud (L)

Department of Radiology, APHP, University Hospitals Paris Nord Val de Seine, Beaujon, Clichy, France.

Onorina Bruno (O)

Department of Radiology, APHP, University Hospitals Paris Nord Val de Seine, Beaujon, Clichy, France.

Audrey Payancé (A)

Department of Hepatology, APHP, University Hospitals Paris Nord Val de Seine, Beaujon, Clichy, France.
University of Paris, Paris, France.

Aurélie Plessier (A)

Department of Hepatology, APHP, University Hospitals Paris Nord Val de Seine, Beaujon, Clichy, France.
University of Paris, Paris, France.

Pierre-Emmanuel Rautou (PE)

Department of Hepatology, APHP, University Hospitals Paris Nord Val de Seine, Beaujon, Clichy, France.
University of Paris, Paris, France.
Inserm, U970, Paris Cardiovascular Research Center - PARCC, University of Paris, Paris, France.
DHU Unity, Pôle des Maladies de l'Appareil Digestif, Service d'Hépatologie, Centre de Référence des Maladies Vasculaires du Foie, Hôpital Beaujon, AP-HP, Clichy, France.

Valérie Paradis (V)

University of Paris, Paris, France.
Department of Pathology, APHP, University Hospitals Paris Nord Val de Seine, Beaujon, Clichy, France.

Dominique Cazals-Hatem (D)

Department of Pathology, APHP, University Hospitals Paris Nord Val de Seine, Beaujon, Clichy, France.

Dominique Valla (D)

Department of Hepatology, APHP, University Hospitals Paris Nord Val de Seine, Beaujon, Clichy, France.
University of Paris, Paris, France.
DHU Unity, Pôle des Maladies de l'Appareil Digestif, Service d'Hépatologie, Centre de Référence des Maladies Vasculaires du Foie, Hôpital Beaujon, AP-HP, Clichy, France.

Valérie Vilgrain (V)

Department of Radiology, APHP, University Hospitals Paris Nord Val de Seine, Beaujon, Clichy, France.
University of Paris, Paris, France.
INSERM U1149, CRI, Paris, France.

Maxime Ronot (M)

Department of Radiology, APHP, University Hospitals Paris Nord Val de Seine, Beaujon, Clichy, France.
University of Paris, Paris, France.
INSERM U1149, CRI, Paris, France.

Classifications MeSH