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The value of gadobenate dimeglumine-enhanced delayed phase MR imaging for characterization of hepatocellular nodules in the cirrhotic liver

 Jung Im Kim  ;  Jeong Min Lee  ;  Jin Young Choi  ;  Young Kon Kim  ;  Se Hyung Kim  ;  Jae Young Lee  ;  Joon Koo Han  ;  Byung Ihn Choi 
 INVESTIGATIVE RADIOLOGY, Vol.43(3) : 202-210, 2008 
Journal Title
Issue Date
Adult ; Aged ; Aged, 80 and over ; Carcinoma, Hepatocellular/complications ; Carcinoma, Hepatocellular/diagnosis* ; Contrast Media ; Female ; Gadolinium DTPA* ; Humans ; Image Enhancement/methods* ; Liver Cirrhosis/complications* ; Liver Cirrhosis/diagnosis ; Liver Neoplasms/complications ; Liver Neoplasms/diagnosis* ; Male ; Middle Aged ; Reproducibility of Results ; Sensitivity and Specificity
contrast media ; magnetic resonance imaging ; carcinoma ; hepatocellular ; liver cirrhosis
OBJECTIVES: To evaluate the value of 1-hour delayed phase imaging (DPI) of gadobenate dimeglumine (Gd-BOPTA)-enhanced MR imaging for the characterization of hepatocellular carcinoma (HCC) and dysplastic nodule (DN) in patients with cirrhosis.

MATERIALS AND METHODS: A total of 37 patients with 42 HCCs and 13 DNs were included in this study and all lesions were histopathologically confirmed except for 15 HCCs. T1-weighted 3-dimensional gradient-echo images were acquired before, immediately after (30, 60, 180 s), and 1 hour after bolus injection of gadobenate dimeglumine at a dose of 0.1 mmol/kg. The lesions were classified as isointense, hypointense, or hyperintense compared with the surrounding liver parenchyma on DPI for qualitative assessment. We performed quantitative analyses of the contrast-to-noise ratio (CNR) and of the relative contrast enhancement of the lesion on the DPI.

RESULTS: In the qualitative analysis, among 42 HCCs, 30 (71.4%) were hypointense on DPI, and 10 (23.8%) and 2 (4.8%) were isointense and hyperintense, respectively; only 1 of 13 DNs (7.7%) was hypointense and 10 (76.9%) and 2 (15.4%) were isointense and hyperintense, respectively. In contrast, 25 HCCs (71.4%) of 35 hypervascular HCCs were hypointense on DPI, and no hypervascular DN (0/7) was hypointense with statistical significance (P = 0.0007). When we considered the hypointensity of the hepatic lesions on delayed phase as a sign of HCC in cirrhotic liver, our results gave a sensitivity of 71.4% and a specificity of 91.7%. In the quantitative analysis, the mean CNR of the HCCs and the DNs on the 1-hour DPI was -6.32 +/- 6.27 and -0.07 +/- 3.28, respectively; the difference between the HCCs and the DNs was significant (P < 0.05).

CONCLUSIONS: Delayed gadobenate dimeglumine-enhanced MR imaging allows improved characterization of HCC in cirrhotic liver. The relative hypointensity to adjacent normal liver parenchyma is a reliable predictor that this lesion favors HCC rather than DN in cirrhotic liver.
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1. College of Medicine (의과대학) > Dept. of Radiology (영상의학교실) > 1. Journal Papers
Yonsei Authors
Choi, Jin Young(최진영) ORCID logo https://orcid.org/0000-0002-9025-6274
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