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Abstract：
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: 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: 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 vs. 33 ± 9 years old, p = 0.003), with higher alpha-fetoprotein (AFP) levels (3/4 [75%] vs. 1/22 [5%] with AFP >15 ng/ml, p <0.001). Homogeneous hypointense signals were identified on HBP in 14 lesions, including 12/12 (100%) HCCs, and 2/99 (2%) benign lesions (p <0.001). Most benign liver lesions showed either peripheral (n = 52/99 [53%]) or homogeneous hyperintensity (n = 23/99 [23%]) on HBP. Lesions with signal hypointensity on HBP in patients with AFP serum levels >15 ng/ml were all HCCs.
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.
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.
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: 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 vs. 33 ± 9 years old, p = 0.003), with higher alpha-fetoprotein (AFP) levels (3/4 [75%] vs. 1/22 [5%] with AFP >15 ng/ml, p <0.001). Homogeneous hypointense signals were identified on HBP in 14 lesions, including 12/12 (100%) HCCs, and 2/99 (2%) benign lesions (p <0.001). Most benign liver lesions showed either peripheral (n = 52/99 [53%]) or homogeneous hyperintensity (n = 23/99 [23%]) on HBP. Lesions with signal hypointensity on HBP in patients with AFP serum levels >15 ng/ml were all HCCs.
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.
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.
摘要：
目的：肝胆阶段（HBP）图像可以区分良性和恶性肝脏病变，但目前尚不清楚这种方法是否可用于Budd-Chiari综合征（BCS）患者。因此，我们旨在评估HBP图像在BCS患者中的诊断效用.
方法：这项回顾性研究包括2000年至2019年在肝胆造影剂增强MR成像（HBCA-MRI）上诊断为BCS和局灶性肝脏病变的所有患者。MR图像由2名对病变诊断不知情的放射科医生进行了审查。记录患者和病变特征，HBP成像特点。
结果：分析了26例患者（平均35±11岁[13-65]；21例女性[81％]35±12岁[13-65]；5例男性[19％]36±10岁[19-44]），其中99例良性肝脏病变和12例肝细胞癌（HCC）。HCC患者的年龄明显高于良性病变患者（平均50±10vs.33±9岁，p=0.003),甲胎蛋白(AFP)水平较高(3/4[75%]vs.1/22[5%]AFP>15ng/ml，p<0.001)。在14个病变的HBP上发现了均匀的低信号，包括12/12(100%)HCC，和2/99（2％）良性病变（p<0.001）。大多数良性肝脏病变在HBP上显示为外周（n=52/99[53％]）或均匀的高强度（n=23/99[23％]）。在AFP血清水平>15ng/ml的患者中，HBP信号下降的病变均为HCC。
结论：大多数良性病变在HBP图像上表现为均匀或周围高强度，而所有HCC均为均匀低信号。HBP图像有助于区分良性病变和HCC，优于其他序列。应系统地获取它们以表征BCS患者的局灶性病变。
背景：肝胆相位成像是一种最近被证明可以区分肝脏良性和恶性病变的方法。然而,尚不清楚这种成像方法能否有效用于Budd-Chiari综合征患者.在这里，我们已经证明,肝胆期相成像似乎可用于区分Budd-Chiari综合征患者的良性和恶性肝脏病变.
方法：这项回顾性研究包括2000年至2019年在肝胆造影剂增强MR成像（HBCA-MRI）上诊断为BCS和局灶性肝脏病变的所有患者。MR图像由2名对病变诊断不知情的放射科医生进行了审查。记录患者和病变特征，HBP成像特点。
结果：分析了26例患者（平均35±11岁[13-65]；21例女性[81％]35±12岁[13-65]；5例男性[19％]36±10岁[19-44]），其中99例良性肝脏病变和12例肝细胞癌（HCC）。HCC患者的年龄明显高于良性病变患者（平均50±10vs.33±9岁，p=0.003),甲胎蛋白(AFP)水平较高(3/4[75%]vs.1/22[5%]AFP>15ng/ml，p<0.001)。在14个病变的HBP上发现了均匀的低信号，包括12/12(100%)HCC，和2/99（2％）良性病变（p<0.001）。大多数良性肝脏病变在HBP上显示为外周（n=52/99[53％]）或均匀的高强度（n=23/99[23％]）。在AFP血清水平>15ng/ml的患者中，HBP信号下降的病变均为HCC。
结论：大多数良性病变在HBP图像上表现为均匀或周围高强度，而所有HCC均为均匀低信号。HBP图像有助于区分良性病变和HCC，优于其他序列。应系统地获取它们以表征BCS患者的局灶性病变。
背景：肝胆相位成像是一种最近被证明可以区分肝脏良性和恶性病变的方法。然而,尚不清楚这种成像方法能否有效用于Budd-Chiari综合征患者.在这里，我们已经证明,肝胆期相成像似乎可用于区分Budd-Chiari综合征患者的良性和恶性肝脏病变.
