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The emergence of non‐hypervascular hypointense nodules on Gd‐EOB‐DTPA‐enhanced MRI in patients with chronic hepatitis C
Author(s) -
Toyoda Hidenori,
Tada Toshifumi,
Yasuda Satoshi,
Mizuno Kazuyuki,
Sone Yasuhiro,
Kaneoka Yuji,
Maeda Atsuyuki,
Akita Tomoyuki,
Tanaka Junko,
Kumada Takashi
Publication year - 2019
Publication title -
alimentary pharmacology and therapeutics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.308
H-Index - 177
eISSN - 1365-2036
pISSN - 0269-2813
DOI - 10.1111/apt.15490
Subject(s) - medicine , hepatocellular carcinoma , incidence (geometry) , gastroenterology , magnetic resonance imaging , chronic hepatitis , risk factor , hepatitis c virus , hepatitis c , radiology , virus , immunology , physics , optics
Summary Background Intrahepatic non‐hypervascular hypointense nodules (NHHNs) detected during the hepatobiliary phase of gadolinium‐ethoxybenzyl‐diethylenetriamine pentaacetic acid‐enhanced magnetic resonance imaging (EOB‐MRI) have the potential to transition into typical hypervascular hepatocellular carcinoma (HCC). However, the incidence and risk factors for the emergence of these nodules in patients with chronic hepatitis C virus (HCV) infection are unknown. Aim To investigate the incidence and risk factors for NHHNs in patients with chronic HCV infection in a longitudinal follow‐up study Methods EOB‐MRI was performed in 608 patients with chronic HCV infection and no history of HCC. The characteristics of patients with and without NHHNs were compared. In patients without NHHNs at baseline, the incidence of NHHN emergence and associated risk factors were analysed. Results NHHNs were detected at baseline in 93 of 608 patients (15.3%). Among 515 patients without NHHNs at baseline, the 1‐year, 3‐year and 5‐year incidence of NHHN emergence was 1.8%, 9.8% and 16.4%, respectively. Only FIB‐4 index was independently associated with the emergence of NHHNs in multivariate analyses. Whereas NHHNs emerged in 24.1% of patients with FIB‐4 index ≥ 3.25 at 5 years, none emerged in patients with FIB‐4 index < 1.45. Conclusion In patients with chronic HCV infection, advanced liver fibrosis is an important risk factor for the presence or emergence of NHHNs.