Indeterminate observations (Liver Imaging Reporting and Data System category 3) on MRI in the cirrhotic liver: Fate and clinical implications

Jin Young Choi, Hyun Cheol Cho, Mark Sun, Hyeon Chang Kim, Claude B. Sirlin

Research output: Contribution to journalArticle

28 Citations (Scopus)

Abstract

OBJECTIVE. The purpose of this article is to retrospectively evaluate the imaging characteristics and outcomes of indeterminate observations (Liver Imaging Reporting and Data System category 3) detected on MRI in patients with cirrhosis. MATERIALS AND METHODS. Sixty-nine indeterminate observations in 52 patients with cirrhosis were imaged with hepatobiliary contrast agent-enhanced MRI. Observations were evaluated retrospectively in terms of the location, size, enhancement pattern, and follow-up results. Each observation was categorized as stable or progressed observations according to serial follow-up MRI. RESULTS. The mean follow-up interval was 11.2 months. Forty-six (67%) of the total observations showed arterial enhancement, and 23 (33%) observations showed isointense signal or low signal intensity on arterial phase. The indeterminate observations were classified as arterial enhancement with fade-out appearance (41 observations [59%]), arterial enhancement with washout appearance (five observations [7%]), and nonhyperenhancing observations (23 observations [33%]). Two of 69 observations (3%) were hyperintense on T2-weighted images, and four of 55 observations (7%) were hyperintense on hepatocellular phase. On the final follow-up MRI examinations, four (6%) observations proved to be probable or definite hepatocellular carcinoma, 55 (80%) remained stable, and 10 (14%) decreased in size or were no longer visible. CONCLUSION. The most common cause of indeterminate observations on MRI is hypervascular pseudolesions that were clinically stable on follow-up imaging.

Original languageEnglish
Pages (from-to)993-1001
Number of pages9
JournalAmerican Journal of Roentgenology
Volume201
Issue number5
DOIs
Publication statusPublished - 2013 Nov 1

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Information Systems
Fibrosis
Liver
Contrast Media
Hepatocellular Carcinoma
Observation

All Science Journal Classification (ASJC) codes

  • Radiology Nuclear Medicine and imaging

Cite this

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title = "Indeterminate observations (Liver Imaging Reporting and Data System category 3) on MRI in the cirrhotic liver: Fate and clinical implications",
abstract = "OBJECTIVE. The purpose of this article is to retrospectively evaluate the imaging characteristics and outcomes of indeterminate observations (Liver Imaging Reporting and Data System category 3) detected on MRI in patients with cirrhosis. MATERIALS AND METHODS. Sixty-nine indeterminate observations in 52 patients with cirrhosis were imaged with hepatobiliary contrast agent-enhanced MRI. Observations were evaluated retrospectively in terms of the location, size, enhancement pattern, and follow-up results. Each observation was categorized as stable or progressed observations according to serial follow-up MRI. RESULTS. The mean follow-up interval was 11.2 months. Forty-six (67{\%}) of the total observations showed arterial enhancement, and 23 (33{\%}) observations showed isointense signal or low signal intensity on arterial phase. The indeterminate observations were classified as arterial enhancement with fade-out appearance (41 observations [59{\%}]), arterial enhancement with washout appearance (five observations [7{\%}]), and nonhyperenhancing observations (23 observations [33{\%}]). Two of 69 observations (3{\%}) were hyperintense on T2-weighted images, and four of 55 observations (7{\%}) were hyperintense on hepatocellular phase. On the final follow-up MRI examinations, four (6{\%}) observations proved to be probable or definite hepatocellular carcinoma, 55 (80{\%}) remained stable, and 10 (14{\%}) decreased in size or were no longer visible. CONCLUSION. The most common cause of indeterminate observations on MRI is hypervascular pseudolesions that were clinically stable on follow-up imaging.",
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Indeterminate observations (Liver Imaging Reporting and Data System category 3) on MRI in the cirrhotic liver : Fate and clinical implications. / Choi, Jin Young; Cho, Hyun Cheol; Sun, Mark; Kim, Hyeon Chang; Sirlin, Claude B.

In: American Journal of Roentgenology, Vol. 201, No. 5, 01.11.2013, p. 993-1001.

Research output: Contribution to journalArticle

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AU - Kim, Hyeon Chang

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N2 - OBJECTIVE. The purpose of this article is to retrospectively evaluate the imaging characteristics and outcomes of indeterminate observations (Liver Imaging Reporting and Data System category 3) detected on MRI in patients with cirrhosis. MATERIALS AND METHODS. Sixty-nine indeterminate observations in 52 patients with cirrhosis were imaged with hepatobiliary contrast agent-enhanced MRI. Observations were evaluated retrospectively in terms of the location, size, enhancement pattern, and follow-up results. Each observation was categorized as stable or progressed observations according to serial follow-up MRI. RESULTS. The mean follow-up interval was 11.2 months. Forty-six (67%) of the total observations showed arterial enhancement, and 23 (33%) observations showed isointense signal or low signal intensity on arterial phase. The indeterminate observations were classified as arterial enhancement with fade-out appearance (41 observations [59%]), arterial enhancement with washout appearance (five observations [7%]), and nonhyperenhancing observations (23 observations [33%]). Two of 69 observations (3%) were hyperintense on T2-weighted images, and four of 55 observations (7%) were hyperintense on hepatocellular phase. On the final follow-up MRI examinations, four (6%) observations proved to be probable or definite hepatocellular carcinoma, 55 (80%) remained stable, and 10 (14%) decreased in size or were no longer visible. CONCLUSION. The most common cause of indeterminate observations on MRI is hypervascular pseudolesions that were clinically stable on follow-up imaging.

AB - OBJECTIVE. The purpose of this article is to retrospectively evaluate the imaging characteristics and outcomes of indeterminate observations (Liver Imaging Reporting and Data System category 3) detected on MRI in patients with cirrhosis. MATERIALS AND METHODS. Sixty-nine indeterminate observations in 52 patients with cirrhosis were imaged with hepatobiliary contrast agent-enhanced MRI. Observations were evaluated retrospectively in terms of the location, size, enhancement pattern, and follow-up results. Each observation was categorized as stable or progressed observations according to serial follow-up MRI. RESULTS. The mean follow-up interval was 11.2 months. Forty-six (67%) of the total observations showed arterial enhancement, and 23 (33%) observations showed isointense signal or low signal intensity on arterial phase. The indeterminate observations were classified as arterial enhancement with fade-out appearance (41 observations [59%]), arterial enhancement with washout appearance (five observations [7%]), and nonhyperenhancing observations (23 observations [33%]). Two of 69 observations (3%) were hyperintense on T2-weighted images, and four of 55 observations (7%) were hyperintense on hepatocellular phase. On the final follow-up MRI examinations, four (6%) observations proved to be probable or definite hepatocellular carcinoma, 55 (80%) remained stable, and 10 (14%) decreased in size or were no longer visible. CONCLUSION. The most common cause of indeterminate observations on MRI is hypervascular pseudolesions that were clinically stable on follow-up imaging.

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