European Radiology

, Volume 17, Issue 7, pp 1898–1905 | Cite as

Thioguanin-induced nodular regenerative hyperplasia of the liver-ROC analysis of different MR techniques

  • Christoph J. ZechEmail author
  • Julia Seiderer
  • Walter Reinisch
  • Thomas Ochsenkuhn
  • Wolfgang Schima
  • Joachim Diebold
  • Fritz Wrba
  • Maximilian F. Reiser
  • Stefan O. Schoenberg


The aim of this study was to evaluate the diagnostic value of different magnetic resonance (MR) techniques for the diagnosis of nodular regenerative hyperplasia (NRH). Thirty-one patients with inflammatory bowel disease, who received 6-thioguanin, underwent liver biopsy and liver MRI on a 1.5-T MR system, with gadolinium and superparamagnetic iron oxide particles (SPIO). MR imaging (MRI) was evaluated independently as well as in consensus by two blinded readers, who received the following image sets: pre-contrast; pre-contrast and gadolinium-enhanced; pre-contrast and SPIO-enhanced and all images. The results were correlated with histopathology and diagnostic efficacy parameters were calculated. NRH was found in 13/31 patients. The set “all images“ showed the highest sensitivity (84.6%), accuracy (77.4%) and negative predictive value (86.7%). However, results for gadolinium were only slightly inferior. The highest specificity (76.5%) was found for SPIO. The Az values of both readers were highest for gadolinium (mean Az = 0.824). It can be concluded that gadolinium-enhanced and SPIO-enhanced MRI enable an accurate diagnosis of NRH. Since gadolinium-enhanced MRI is very sensitive, it should be used for screening high-risk patients. SPIO-enhanced MRI is less sensitive, but more specific. The combination of both guarantees a high sensitivity and specificity and, therefore, is the diagnostic procedure of choice.


MR imaging Liver-specific contrast agents Diffuse liver disease Nodular regenerative hyperplasia 


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Copyright information

© Springer-Verlag 2007

Authors and Affiliations

  • Christoph J. Zech
    • 1
    Email author
  • Julia Seiderer
    • 2
  • Walter Reinisch
    • 3
  • Thomas Ochsenkuhn
    • 2
  • Wolfgang Schima
    • 4
  • Joachim Diebold
    • 5
  • Fritz Wrba
    • 6
  • Maximilian F. Reiser
    • 1
  • Stefan O. Schoenberg
    • 1
  1. 1.Institute of Clinical RadiologyMunich University Hospitals - GrosshadernMunichGermany
  2. 2.Department of Gastroenterology, University Hospitals-GrosshadernLudwig-Maximilians-University MunichMunichGermany
  3. 3.Department of Internal Medicine IVMedical University of ViennaViennaAustria
  4. 4.Department of RadiologyMedical University of ViennaViennaAustria
  5. 5.Institute of PathologyLudwig-Maximilians-University MunichMunichGermany
  6. 6.Department of PathologyMedical University of ViennaViennaAustria

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