Differentiation between dysplastic nodule and early-stage hepatocellular carcinoma: The utility of conventional MR imaging

Table 1 Clinical characteristics of the 73 cirrhotic patients with liver nodules

	Histopathological diagnosis			P value
	DN (n = 14)	w1-HCC (n = 40)	w2-HCC (n = 19)
Age (mean ± SD, yr)	54.9 ± 12.9	62.4 ± 12.2	63.4 ± 10.8	0.129
Sex				0.629
Male	11	27	12
Female	3	13	7
Underlying liver disease				0.640
HBV	7	15	7
HCV	3	15	10
HBV + HCV	2	6	1
Alcoholism	2	4	1
Child-Pugh class				0.645
A	10	25	14
B	4	15	5
Tumor size (mean ± SD, cm)	1.8 ± 0.6	2.1 ± 0.7	2.9 ± 2.3	0.365
AFP (mean ± SD, ng/mL)	17.1 ± 27.9	55.5 ± 117.9	64.2 ± 169.7	0.202
< 20 ng/mL	12	28	13	0.790
≥ 20 ng/mL	2	12	6
> 20, ≤ 100 ng/mL	2	7	4
> 100, ≤ 200 ng/mL	0	0	1
> 200 ng/mL	0	5	1

HBV: Hepatitis B virus; HCV: Hepatitis C virus; AFP: Alpha-fetal protein; DN: Dysplastic nodule; w1-HCC: Well-differentiated hepatocellular carcinoma compatible with Edmondson-Steiner grade I; w2-HCC Well-differentiated hepatocellular carcinoma compatible with Edmondson-Steiner grade II.

Table 2 Interobserver agreement for magnetic resonance features

MR features	k value
T1-weighted in-phase imaging	0.853
T1-weighted opposed-phase imaging	0.870
Fatty metamorphosis	0.819
T2-weighted imaging	0.828
Arterial enhancement	0.806
Late-phase T1-weighted imaging	0.743

MR: Magnetic resonance.

Table 3 Comparison of magnetic resonance features between dysplastic nodule and well-differentiated hepatocellular carcinoma

	DN (n = 14)	wHCC		P value
		w1 (n = 40)	w2 (n = 19)	DN vs wHCC	DN vs w1	w1 vs w2
In-phase T1WI				0.469	0.405	0.074
Hyperintense	8	29	8
Isointense	4	5	4
Hypointense	2	6	7
Opposed-phase T1WI				0.661	0.565	0.007
Hyperintense	8	25	4
Isointense	3	4	6
Hypointense	3	11	9
Fatty metamorphosis				0.192	0.311	0.450
Positive	0	5	4
Negative	14	35	15
T2WI				0.006	0.020	0.109
Hyperintense	1	14	12
Isointense	6	5	2
Hypointense	7	21	5
Arterial enhancement				0.767	0.753	0.005
Hypervascular	5	12	13
Iso-/hypo-vascular	9	28	6
Late-phase T1WI				0.112	0.286	0.105
Hyperintense	1	5	3
Isointense	12	26	7
Hypointense	1	9	9

T1WI: T1-weighted imaging; T2WI: T2-weighted imaging; DN: Dysplastic nodule; wHCC: Well-differentiated hepatocellular carcinoma; w1: wHCC compatible with Edmondson-Steiner grade I; w2: wHCC compatible with Edmondson-Steiner grade II.