자기공명영상 경동맥 문맥조영술을 통한 간세포암의 진단

Abstract

Purpose : To evaluate the usefulness of fast magnetic resonance (MR) sequences combined with MR arterialportography in the preoperative assessment of hepatocellular carcinoma. Materials and Methods : Twelve patientssuffering from nodular hepatocellular carcinoma complicated by liver cirrhosis underwent T2-weighted turbo spinecho and T1-weighted multisection FLASH with and without fat-suppression MR imaging during single breath-holdsession in each sequence. MR arterial portography was performed with Gd-DTPA injected through a catheter into thesuperior mesenteric or splenic artery during the T1-weighted FLASH sequence. The pathologic findings of surgicalspecimen or follow-up lipiodol CT findings were compared with the MR imaging. Results : MR arterial portographydepicted 17 of the 19 masses (sensitivity, 89%) and the sensitivity of non-contrast fast MR sequences was 74%(14\19). The sensitivity for combined interpretation of all the above sequences was 89% (17/19). MR arterialportography showed perfusion defects from two cysts, one hemangioma, one inflammatory mass, and innumerable tinyregenerating nodules. Static T1-and T2-weighted imaging clearly differentiated, however, benign lesions and truehepatocellular carcinoma. Conclusion : MR arterial portography combined with other fast MR imaging allows tissuecharacterization as well as high detection rate in the evaluation of hepatocellular carcinoma complicated withcirrhosis.