Presence of a hypovascular hepatic nodule showing hypointensity on hepatocyte-phase image is a risk factor for hypervascular hepatocellular carcinoma

J Magn Reson Imaging. 2014 Feb;39(2):293-7. doi: 10.1002/jmri.24164. Epub 2013 Apr 30.


Purpose: To determine whether the presence of a hypovascular nodule in the liver showing hypointensity on hepatocyte-phase of gadoxetic acid-enhanced magnetic resonance imaging (EOB-MRI) is a risk factor for hypervascular hepatocellular carcinoma (HCC) in patients with chronic liver disease.

Materials and methods: Forty-one patients with pathologically confirmed hypervascular HCC and 41 age- and gender-matched controls were retrospectively selected. These patients had undergone EOB-MRI at least twice: the latest EOB-MRI and EOB-MRI performed more than 6 months earlier. History of hypervascular HCC, presence of a hypointense hypovascular nodule in previous hepatocyte-phase MR images, percent prothrombin time, platelet count, serum levels of albumin, total bilirubin, aspartate aminotransferase, alanine aminotransferase, α-fetoprotein, and protein induced by vitamin K absence-II (PIVKA-II) were variables evaluated by multivariate logistic regression analysis.

Results: Multivariate analysis revealed that serum albumin level (odds ratio [95% confidence interval], 0.19 [0.06-0.57]; P = 0.0024), history of hypervascular HCC (8.62 [2.71-32.8]; P = 0.0001), and presence of a hypointense hypovascular nodule (4.18 [1.18-17.2]; P = 0.0256) were significant risk factors for hypervascular HCC.

Conclusion: Patients with chronic liver disease showing a hypointense hypovascular nodule in the liver on hepatocyte-phase EOB-MRI have a high risk of HCC development.

Keywords: gadoxetic acid; hepatocellular carcinoma; hepatocyte phase; magnetic resonance imaging; risk factors.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Carcinoma, Hepatocellular / blood supply*
  • Carcinoma, Hepatocellular / pathology*
  • Case-Control Studies
  • Contrast Media
  • Female
  • Gadolinium DTPA
  • Hepatocytes / pathology*
  • Humans
  • Liver Cirrhosis / pathology
  • Liver Neoplasms / blood supply*
  • Liver Neoplasms / pathology*
  • Magnetic Resonance Imaging / methods*
  • Male
  • Middle Aged
  • Neovascularization, Pathologic / pathology*
  • Prognosis
  • Reproducibility of Results
  • Retrospective Studies
  • Risk Factors
  • Sensitivity and Specificity


  • Contrast Media
  • gadolinium ethoxybenzyl DTPA
  • Gadolinium DTPA