Hepatobiliary agents and their role in LI-RADS

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• 作者：Thomas A. Hope (1)
  Kathryn J. Fowler (2)
  Claude B. Sirlin (3)
  Eduardo A. C. Costa (3)
  Judy Yee (1)
  Benjamin M. Yeh (1)
  Jay P. Heiken (2)
  
  1. Department of Radiology and Biomedical Imaging ; University of California San Francisco ; 505 Parnassus Avenue 鈥?0628 ; San Francisco ; CA ; 94143-0628 ; USA
  2. Department of Radiology ; Washington University School of Medicine ; St. Louis ; MO ; USA
  3. Liver Imaging Group ; Department of Radiology ; University of California San Diego ; San Diego ; CA ; USA
  
• 关键词：Hepatocellular carcinoma ; Hepatobiliary agents ; Liver ; LI ; RADS ; Gadoxetate ; Gadobenate dimeglumine
• 刊名：Abdominal Imaging
• 出版年：2015
• 出版时间：March 2015
• 年：2015
• 卷：40
• 期：3
• 页码：613-625
• 全文大小：2,151 KB
• 参考文献：1. American College of Radiology (2013) / Liver imaging reporting and data system (LI-RADS). American College of Radiology, Washington, DC. http://www.acr.org/Quality-Safety/Resources/LIRADS. Accessed 25 May 2014
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  4. Tamada T, Ito K, Higaki A, Yoshida K, et al. (2011) Gd-EOB-DTPA-enhanced MR imaging: evaluation of hepatic enhancement effects in normal and cirrhotic livers. Eur J Radiol 80(3):e311鈥揺316 CrossRef
  5. Motosugi U, Ichikawa T, Sou H, Sano K, et al. (2009) Liver parenchymal enhancement of hepatocyte-phase images in Gd-EOB-DTPA-enhanced MR imaging: which biological markers of the liver function affect the enhancement? J Magn Reson Imaging 30(5):1042鈥?046 CrossRef
  6. Lee NK, Kim S, Kim GH, Heo J, et al. (2012) Significance of the 鈥渄elayed hyperintense portal vein sign鈥?in the hepatobiliary phase MRI obtained with Gd-EOB-DTPA. J Magn Reson Imaging 36(3):678鈥?85 CrossRef
  7. Kim JY, Lee SS, Byun JH, Kim SY, et al. (2013) Biologic factors affecting HCC conspicuity in hepatobiliary phase imaging with liver-specific contrast agents. Am J Roentgenol 201(2):322鈥?31 CrossRef
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  14. Tamada T, Ito K, Yoshida K, Kanki A, et al. (2011) Comparison of three different injection methods for arterial phase of Gd-EOB-DTPA enhanced MR imaging of the liver. Eur J Radiol 80(3):e284鈥揺288 CrossRef
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  16. Motosugi U, Ichikawa T, Sou H, Sano K, et al. (2009) Dilution method of gadolinium ethoxybenzyl diethylenetriaminepentaacetic acid (Gd-EOB-DTPA)-enhanced magnetic resonance imaging (MRI). J Magn Reson Imaging 30(4):849鈥?54 CrossRef
  17. Davenport MS, Viglianti BL, Al-Hawary MM, Caoili EM, et al. (2013) Comparison of acute transient dyspnea after intravenous administration of gadoxetate disodium and gadobenate dimeglumine: effect on arterial phase image quality. Radiology 266(2):452鈥?61 CrossRef
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• 刊物类别：Medicine
• 刊物主题：Medicine & Public Health
  Imaging and Radiology
  Gastroenterology
  Hepatology
  
• 出版者：Springer New York
• ISSN：1432-0509

文摘

The Liver Imaging Reporting and Data System (LI-RADS) was introduced with the goal of standardizing the diagnosis of hepatocellular carcinoma. The 2014 version of LI-RADS incorporates the use of hepatobiliary contrast agents (HBAs) into the diagnostic algorithm, including gadoxetate disodium and gadobenate dimeglumine. Three new ancillary features are introduced: hepatobiliary phase (HBP) hypointensity and HBP hypointense rim favor malignancy, while HBP isointensity favors benignity. HBP hyperintensity favors neither malignancy nor benignity. In this review, we describe how to use these new features as well as numerous pitfalls associated with the use ofHBAs, including hemangiomas, cholangiocarcinomas, and focal confluent fibrosis. Importantly, findings on the HBP are not included as major criteria and therefore the criteria for the diagnosis of LI-RADS 5 observations remain unchanged, and so congruence with the Organ Procurement Transplant Network system remains intact. Additionally, we review how the major features in LI-RADS, arterial phase hyperenhancement, threshold growth, and washout and capsule appearance, may be affected with HBAs. Notably with HBAs, hypointensity on the delayed phase, termed the transitional phase, does not qualify as washout appearance due to the possibility of early parenchymal enhancement. It is hoped that the incorporation of HBAs into LI-RADS will help create consistency when interpreting HBA enhanced MRIs.