From: HBP-enhancing hepatocellular adenomas and how to discriminate them from FNH in Gd-EOB MRI
Reader 1 | Reader 2 | p value | |||||
---|---|---|---|---|---|---|---|
Overall n = 68 | FNH n = 28 | HCA n = 40 | Overall n = 68 | FNH n = 28 | HCA n = 40 | ||
Patient characteristics | |||||||
Sex (female) | 87% (59) | 100% (28) | 77.5% (31) | – | – | – | 0.007 |
Age (years) | 40 ± 12 | 38 ± 10 | 43 ± 13 | – | – | – | > 0.05* |
Lesion diameter (mm) | 59 ± 36 | 64 ± 34 | 56 ± 39 | – | – | – | > 0.05* |
Steatosis | 41% (28) | 14.5% (4) | 35% (14) | – | – | – | 0.227 |
HCA subtypes | |||||||
IHCA | 54.5% (37) | – | 92.5% (37) | – | – | – | – |
HHCA | 1.5% (1) | – | 2.5% (1) | – | – | – | – |
bHCA | 1.5% (1) | – | 2.5% (1) | – | – | – | – |
uHCA | 1.5% (1) | – | 2.5% (1) | – | – | – | – |
Accuracy (%) | 94% (64) | 89% (25) | 97.5% (39) | 94% (64) | 100% (28) | 90% (36) | < 0.001 (0.835) |
Intralesional Gd-EOB uptake scores | |||||||
Score 4: > 75% | 40% (27) | 82% (23) | 12.5% (5) | 47% (32) | 96.5% (27) | 12.5% (5) | |
Score 3: 50–75% | 19% (13) | 7% (2) | 27.5% (11) | 20.5% (14) | 0 | 35% (14) | |
Score 2: 25–50% | 41% (28) | 11% (3) | 60% (24) | 32.5% (22) | 3.5% (1) | 52.5% (21) | |
Score 1: 5–25% | 0 | 0 | 0 | 0 | 0 | 0 | < 0.001* |
Score 0: < 5% Interreader correlation | 0 | 0 | 0 | 0 | 0 | 0 | < 0.001 (0.872) |
Intralesional Gd-EOB uptake | |||||||
Entirely enhancing lesion | 40% (27) | 82% (23) | 12.5% (5) | 47% (32) | 96.5% (27) | 12.5% (5) | |
Significantly enhancinglesion | 60% (41) | 8% (5) | 87.5% (35) | 53% (36) | 3.5% (1) | 87.5% (35) | < 0.001* |
Gd-EOB uptake pattern | |||||||
Homogeneous | 79.5% (54) | 93% (26) | 30% (12) | 69% (47) | 86% (24) | 57.5% (23) | < 0.001* |
Heterogeneous / patchy Interreader correlation | 20.5% (14) | 7% (2) | 70% (28) | 31% (21) | 14% (4) | 42.5% (17) | < 0.001 (0.604) |
CE behavior** | n = 65* | n = 25* | n = 40* | n = 65* | n = 25* | n = 40* | |
Qualitative | |||||||
Art. hyperenhancement | 89% (58) | 88% (22) | 87.5% (35) | 89% (58) | 96% (24) | 85% (34) | 0.952* |
Portal venous wash-out | 9% (6) | 4% (1) | 12.5% (5) | 14% (9) | 8% (2) | 17.5% (7) | 0.249* |
Quantitative | |||||||
Arterial phase | 339.2 ± 223.2 | 290.2 ± 197.5 | 358..0 ± 241.0 | – | – | – | 0.279 |
Poral venous phase | 118.9 ± 49.5 | 132.9 ± 43.4 | 110.2 ± 51.4 | – | – | – | 0.048 |
Venous phase | 108.7 ± 42.6 | 122.0 ± 32.6 | 100.3 ± 46.2 | – | – | – | 0.107 |
Hepatobiliary phase | 79.7 ± 45.8 | 110.3 ± 39.2 | 59.2 ± 38.0 | – | – | – | < 0.001 |
Qualitive MRI features | |||||||
Lobulated appearance | 55% (36) | 89% (25) | 27.5% (11) | 54.5% (37) | 82% (23) | 35% (14) | < 0.001* |
Pseudocapsule | 17.5% (12) | 11% (3) | 22.5% (9) | 28% (19) | 32% (9) | 25% (10) | 0.210* |
Central scar | 35.5% (24) | 46.5% (13) | 27.5% (11) | 56% (38) | 89.5% (25) | 32.5% (13) | 0.046* |
Intralesional fat | 9% (6) | 8% (2) | 10% (4) | 10.5% (7) | 8% (2) | 12.5% (5) | 0.768* |
Atoll sign | 10.5% (7) | 4% (1) | 15% (6) | 19% (13) | 3.3% (1) | 30% (12) | 0.164* |