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Year : 2019  |  Volume : 25  |  Issue : 1  |  Page : 7-21

Cirrhosis-associated liver nodules in Egyptian patients: correlation of histopathologic and MRI with diffusion findings

1 Department of Radiology, Faculty of Medicine, Cairo University, Cairo, Egypt
2 Department of Endemic Medicine and Hepatology, Faculty of Medicine, Cairo University, Cairo, Egypt

Correspondence Address:
Lamiaa I.A Metwally
Assistant Professor, Department of Radiology, Faculty of Medicine, Cairo University, Kasr Al Ainy hospital, Al-Saray St., El Manial, Cairo, 11956
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/kamj.kamj_9_19

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Aim This study aimed to examine the role of enhanced MRI combined with diffusion in the characterization of cirrhotic nodules, to differentiate benign cirrhotic nodules from premalignant and malignant ones, and to determine treatment planning and management. Patients and methods Precontrast T1, T2, T2-Spectral Attenuated Inversion Recovery, in-phase and out-phase gradient echo sequence, dynamic contrast-enhanced, and diffusion-weighted MRI, b values (0, 500, 1000 s/mm) were obtained in 40 patients with cirrhotic liver (total of 58 focal nodules). The morphological features of each lesion were recorded: size, shape, margin, signal, pattern of contrast enhancement, number, and site of focal lesions in the diffusion images with apparent diffusion coefficient values. Results Lesions were divided according to MR diagnosis and divided histopathologically into four groups: group A: malignant, group B: premalignant (dysplastic), group C: regeneration, and group D: siderotic nodules. Histopathologically, they were divided into 26 hepatocellular carcinoma, nine low-grade dysplastic, nine high-grade dysplastic, 12 regeneration, and two siderotic nodules. The accuracy of MRI was 93%, the sensitivity was 100%, and the specificity was 70% in this study. Conclusion Contrast-enhanced MRI with diffusion-weighted imaging is sensitive for early detection of malignant neoplastic hepatic lesions, and for differentiation between premalignant and malignant lesions.

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