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Histological characteristics of small hepatocellular carcinomas showing atypical enhancement patterns on gadoxetic acid-enhanced MR imaging

 Yoon Seong Choi  ;  Hyungjin Rhee  ;  Jin-Young Choi  ;  Yong Eun Chung  ;  Young Nyun Park  ;  Ki Whang Kim  ;  Myeong-Jin Kim 
 Journal of Magnetic Resonance Imaging, Vol.37(6) : 1384-1391, 2013 
Journal Title
 Journal of Magnetic Resonance Imaging 
Issue Date
Carcinoma, Hepatocellular/pathology* ; Contrast Media ; Female ; Gadolinium DTPA* ; Humans ; Liver Neoplasms/pathology* ; Magnetic Resonance Imaging/methods* ; Male ; Middle Aged ; Observer Variation ; Reproducibility of Results ; Sensitivity and Specificity
PURPOSE: To define the histological characteristics of hepatocellular carcinomas (HCCs) showing atypical dynamic enhancement patterns on gadoxetic acid-enhanced dynamic magnetic resonance imaging (EOB-MRI). MATERIALS AND METHODS: We evaluated a total of 130 small (≤ 3 cm) HCCs from 114 patients that were surgically removed after EOB-MRI. Two radiologists blinded to the histological findings retrospectively classified the HCCs into typical or atypical lesions. Gross morphology, nuclear histological grade, presence of vascular invasion, and capsule formation and infiltration were compared between the two groups using Chi-square or Fisher tests. RESULTS: Atypical dynamic enhancement patterns were seen in 23 HCCs (17.7%). None of the atypical HCC showed vascular invasion (P < 0.001). Atypical HCCs also showed more frequently smaller size (1.6 ± 0.6 cm versus 2.1 ± 0.6 cm, P = 0.001) with 86.9% (n = 20) of which 2 cm or less in diameter (P = 0.001), vaguely nodular appearance (56.5% vs 3.7%, P < 0.001), and nuclear grade I (69.6% versus 6.5%, P < 0.001), while less frequently showed capsule formation (26.1% versus 77.6%, P < 0.001) or capsular infiltration (16.7% versus 77.1%, P = 0.005). CONCLUSION: Atypical HCCs on EOB-MRI may be characterized by the absence of vascular invasion, smaller (< 2 cm or less) size, vaguely nodular appearance, and well differentiation, and infrequent capsule formation or capsular infiltration.
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1. College of Medicine (의과대학) > Dept. of Radiology (영상의학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Pathology (병리학교실) > 1. Journal Papers
Yonsei Authors
김기황(Kim, Ki Whang)
김명진(Kim, Myeong Jin) ORCID logo https://orcid.org/0000-0001-7949-5402
박영년(Park, Young Nyun) ORCID logo https://orcid.org/0000-0003-0357-7967
이형진(Rhee, Hyungjin) ORCID logo https://orcid.org/0000-0001-7759-4458
정용은(Chung, Yong Eun) ORCID logo https://orcid.org/0000-0003-0811-9578
최윤성(Choi, Yoon Seong)
최진영(Choi, Jin Young) ORCID logo https://orcid.org/0000-0002-9025-6274
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