HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Abstract Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Yu, J.-S. Articles by Kim, K. W. Search for Related Content PubMed PubMed Citation Articles by Yu, J.-S. Articles by Kim, K. W. Social Bookmarking                      What's this? Hotlight (NEW!) What's Hotlight?

Fat-Containing Nodules in the Cirrhotic Liver: Chemical Shift MRI Features and Clinical Implications

¹ All authors: Department of Radiology, Yonsei University College of Medicine, YongDong Severance Hospital, 146-92 Dogok-Dong, Gangnam-Gu, Seoul 135-720, South Korea.

View larger version (147K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 1A —57-year-old man with 2.3-cm fat-containing hepatocellular carcinoma (group A, category I) in background of early cirrhotic change from chronic B-viral hepatitis. Transverse opposed-phase gradient-echo MR image (TR/TE, 140/2.3; flip angle, 90°) shows low-signal-intensity nodule (arrow) in right lobe of liver.

View larger version (129K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 1B —57-year-old man with 2.3-cm fat-containing hepatocellular carcinoma (group A, category I) in background of early cirrhotic change from chronic B-viral hepatitis. In-phase image (TE, 5.3) corresponding to A also shows hypointensity of same nodule (arrow).

View larger version (130K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 1C —57-year-old man with 2.3-cm fat-containing hepatocellular carcinoma (group A, category I) in background of early cirrhotic change from chronic B-viral hepatitis. Bright signal intensity area (arrow) on subtracted image of opposed-phase image from in-phase image suggests intralesional fat component that was difficult to identify by direct comparison of in-phase and opposed-phase images.

View larger version (147K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 1D —57-year-old man with 2.3-cm fat-containing hepatocellular carcinoma (group A, category I) in background of early cirrhotic change from chronic B-viral hepatitis. Transverse T2-weighted turbo spin-echo MR image (4,000/138) of liver shows mild hyperintensity of nodule (arrow) despite chemically selective fat suppression.

View larger version (140K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 1E —57-year-old man with 2.3-cm fat-containing hepatocellular carcinoma (group A, category I) in background of early cirrhotic change from chronic B-viral hepatitis. Transverse arterial phase dynamic in-phase MR image still shows relative hypointensity of main nodule (arrow), which was regarded as hypovascular lesion. Well-differentiated hepatocellular carcinoma with fatty change was verified by partial hepatectomy.

View larger version (134K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 2A —62-year-old man with 0.6-cm fat-containing nodule (group A) in advanced cirrhotic liver from chronic B-viral hepatitis. Nodule had transformed to hypervascular hepatocellular carcinoma (category II) at 13-month follow-up imaging. Transverse opposed-phase gradient-echo MR image (TR/TE, 140/2.3; flip angle, 90°) shows subcapsular low-signal-intensity nodule (white arrowhead) in right lobe of liver.

View larger version (132K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 2B —62-year-old man with 0.6-cm fat-containing nodule (group A) in advanced cirrhotic liver from chronic B-viral hepatitis. Nodule had transformed to hypervascular hepatocellular carcinoma (category II) at 13-month follow-up imaging. In-phase image (TE, 5.3) corresponding to A shows poorly defined hyperintensity at same site (white arrowhead). T2-weighted hyperintensity or arterial hypervascularity was not revealed on initial MR images (not shown).

View larger version (134K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 2C —62-year-old man with 0.6-cm fat-containing nodule (group A) in advanced cirrhotic liver from chronic B-viral hepatitis. Nodule had transformed to hypervascular hepatocellular carcinoma (category II) at 13-month follow-up imaging. At 13-month follow-up, transverse arterial phase dynamic opposed-phase MR image shows 1.5-cm hypervascular lesion at same location (arrow). Hepatic arteriography revealed hypervascular lesion, suggesting hepatocellular carcinoma, and iodized oil accumulation was sustained after chemoembolization (not shown). Larger nonfatty hyperintense nodule in segment VIII (black arrowheads on A and B) shows no hypervascularity, but it gradually enlarged on further follow-up imaging studies, suggesting a dysplastic nodule or well-differentiated hepatocellular carcinoma.

View larger version (144K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 3A —41-year-old man with numerous small fatty nodules (group B) in diffuse steatotic background of macronodular cirrhosis from chronic B-viral hepatitis with no malignant transformation during more than 5-year follow-up (category VI). Transverse T1-weighted opposed-phase gradient-echo MR image (TR/TE, 140/2.7) shows inhomogeneous background signal intensity of advanced cirrhotic liver containing numerous hypointense nodules (arrowheads).

View larger version (129K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 3B —41-year-old man with numerous small fatty nodules (group B) in diffuse steatotic background of macronodular cirrhosis from chronic B-viral hepatitis with no malignant transformation during more than 5-year follow-up (category VI). In-phase image (TE, 5.3) corresponding to A shows relatively homogeneous background signal intensity in another hyperintense nodule (arrowhead).

View larger version (141K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 3C —41-year-old man with numerous small fatty nodules (group B) in diffuse steatotic background of macronodular cirrhosis from chronic B-viral hepatitis with no malignant transformation during more than 5-year follow-up (category VI). Numerous small hyperintense nodules are scattered in cirrhotic background of diffuse steatosis, including nodules indicated on A and B (arrowheads). No T2-weighted hyperintensity or arterial hypervascularity was seen on initial MR images (not shown).

View larger version (136K): [in this window] [in a new window] [as a PowerPoint slide]   Fig. 3D —41-year-old man with numerous small fatty nodules (group B) in diffuse steatotic background of macronodular cirrhosis from chronic B-viral hepatitis with no malignant transformation during more than 5-year follow-up (category VI). CT scan obtained 52 months after initial MRI shows diffuse inhomogeneous attenuation densities with no distinguishable focal lesion from advanced cirrhotic background. Arterial and portal phase dynamic CT also showed no focal lesion (not shown).

CiteULike

Complore

Connotea

Del.icio.us

Digg

Reddit

Technorati