Hepatobiliary MR contrast agents are useful to diagnose hepatocellular carcinoma in patients with Budd-Chiari syndrome
Morgane Van Wettere,
Luisa Paulatto,
Lucas Raynaud,
Onorina Bruno,
Audrey Payancé,
Aurélie Plessier,
Pierre-Emmanuel Rautou,
Valérie Paradis,
Dominique Cazals-Hatem,
Dominique Valla,
Valérie Vilgrain,
Maxime Ronot
Affiliations
Morgane Van Wettere
Department of Radiology, APHP, University Hospitals Paris Nord Val de Seine, Beaujon, Clichy, France
Luisa Paulatto
Department of Radiology, APHP, University Hospitals Paris Nord Val de Seine, Beaujon, Clichy, France
Lucas Raynaud
Department of Radiology, APHP, University Hospitals Paris Nord Val de Seine, Beaujon, Clichy, France
Onorina Bruno
Department of Radiology, APHP, University Hospitals Paris Nord Val de Seine, Beaujon, Clichy, France
Audrey Payancé
Department of Hepatology, APHP, University Hospitals Paris Nord Val de Seine, Beaujon, Clichy, France; University of Paris, Paris, France
Aurélie Plessier
Department of Hepatology, APHP, University Hospitals Paris Nord Val de Seine, Beaujon, Clichy, France; University of Paris, Paris, France
Pierre-Emmanuel Rautou
Department of Hepatology, APHP, University Hospitals Paris Nord Val de Seine, Beaujon, Clichy, France; University of Paris, Paris, France; Inserm, U970, Paris Cardiovascular Research Center - PARCC, University of Paris, Paris, France; DHU Unity, Pôle des Maladies de l'Appareil Digestif, Service d'Hépatologie, Centre de Référence des Maladies Vasculaires du Foie, Hôpital Beaujon, AP-HP, Clichy, France
Valérie Paradis
University of Paris, Paris, France; Department of Pathology, APHP, University Hospitals Paris Nord Val de Seine, Beaujon, Clichy, France
Dominique Cazals-Hatem
Department of Pathology, APHP, University Hospitals Paris Nord Val de Seine, Beaujon, Clichy, France
Dominique Valla
Department of Hepatology, APHP, University Hospitals Paris Nord Val de Seine, Beaujon, Clichy, France; University of Paris, Paris, France; DHU Unity, Pôle des Maladies de l'Appareil Digestif, Service d'Hépatologie, Centre de Référence des Maladies Vasculaires du Foie, Hôpital Beaujon, AP-HP, Clichy, France
Valérie Vilgrain
Department of Radiology, APHP, University Hospitals Paris Nord Val de Seine, Beaujon, Clichy, France; University of Paris, Paris, France; INSERM U1149, CRI, Paris, France
Maxime Ronot
Department of Radiology, APHP, University Hospitals Paris Nord Val de Seine, Beaujon, Clichy, France; University of Paris, Paris, France; INSERM U1149, CRI, Paris, France; Corresponding author. Address: Department of Radiology, Beaujon Hospital, AP-HP, 100 Boulevard du Général Leclerc, 92118 Clichy, France. Tel.: + 33 140875566, fax: + 33 140870548.
Background & Aims: Hepatobiliary phase (HBP) images can discriminate between benign and malignant liver lesions, but it is unclear if this approach can be used in patients with Budd-Chiari syndrome (BCS). Thus, we aimed to assess the diagnostic utility of HBP images in patients with BCS. Methods: This retrospective study included all patients admitted to our institution with a diagnosis of BCS and focal liver lesions on hepatobiliary contrast agent-enhanced MR imaging (HBCA-MRI) from 2000 to 2019. MR images were reviewed by 2 radiologists blinded to the diagnosis of the lesions. Patient and lesion characteristics were recorded, focusing on HBP imaging features. Results: Twenty-six patients (mean 35 ± 11 years old [13–65]; 21 women [81%] 35 ± 12 years old [13–65]; 5 men [19%] 36 ± 10 years old [19–44]) with 99 benign liver lesions and 12 hepatocellular carcinomas (HCCs) were analyzed. Patients with HCC were significantly older than those with benign lesions (mean 50 ± 10 vs. 33 ± 9 years old, p = 0.003), with higher alpha-fetoprotein (AFP) levels (3/4 [75%] vs. 1/22 [5%] with AFP >15 ng/ml, p 15 ng/ml were all HCCs. Conclusion: Most benign lesions showed homogeneous or peripheral hyperintensity on HBP images while all HCCs were homogeneously hypointense. HBP images are helpful to differentiate between benign lesions and HCCs and outperform other sequences. They should be systematically acquired for the characterization of focal lesions in patients with BCS. Lay summary: Hepatobiliary phase imaging is an approach that has recently been shown to discriminate between benign and malignant lesions in the liver. However, it was not known whether this imaging approach could be used effectively in patients with Budd-Chiari syndrome. Herein, we have shown that hepatobiliary phase imaging appears to be useful for differentiating between benign and malignant liver lesions in patients with Budd-Chiari syndrome.
