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Small hypervascular hepatocellular carcinomas: value of diffusion-weighted imaging compared with "washout" appearance on dynamic MRI.

Authors
 D J Kim  ;  J-S Yu  ;  J H Kim  ;  J-J Chung  ;  K W Kim 
Citation
 BRITISH JOURNAL OF RADIOLOGY, Vol.85(1018) : 879-886, 2012 
Journal Title
BRITISH JOURNAL OF RADIOLOGY
ISSN
 0007-1285 
Issue Date
2012
MeSH
Adult ; Aged ; Aged, 80 and over ; Carcinoma, Hepatocellular/blood supply ; Carcinoma, Hepatocellular/diagnosis* ; Diffusion Magnetic Resonance Imaging/methods* ; Early Detection of Cancer/methods ; Female ; Humans ; Liver Neoplasms/blood supply ; Liver Neoplasms/diagnosis* ; Magnetic Resonance Angiography/methods* ; Male ; Middle Aged ; Retrospective Studies
Keywords
Adult ; Aged ; Aged, 80 and over ; Carcinoma, Hepatocellular/blood supply ; Carcinoma, Hepatocellular/diagnosis* ; Diffusion Magnetic Resonance Imaging/methods* ; Early Detection of Cancer/methods ; Female ; Humans ; Liver Neoplasms/blood supply ; Liver Neoplasms/diagnosis* ; Magnetic Resonance Angiography/methods* ; Male ; Middle Aged ; Retrospective Studies
Abstract
OBJECTIVE: To compare the value of diffusion-weighted MRI (DWI) with the venous "washout" appearance during dynamic MRI for the assessment of small arterial hypervascular lesions in cirrhotic liver.

METHODS: After exclusion of benign hypervascular lesions, including haemangiomas and subcapsular non-tumorous arterioportal shunts, indicated by typical imaging features, a total of 109 small arterial hypervascular lesions (0.5-3.0 cm in the longest diameter) in 65 patients with cirrhosis who underwent gadopentetate dimeglumine-enhanced dynamic MRI and DWI (b=50, 400, 800 s mm(-2)) at 1.5 T during a 16-month period were retrospectively analysed to determine the presence of venous washout during dynamic imaging or sustained hyperintensity upon increasing the b factor size on DWI.

RESULTS: Among the 99 hypervascular hepatocellular carcinomas (HCCs), sustained hyperintensity on DWI (92/99, 93%) was more prevalent than the washout appearance (72/99, 72%) on dynamic MRI (p<0.001). Depending on the lesion size, subcentimetre-sized HCCs had a significantly lower prevalence of venous washout (13/30, 43%) than the sustained hyperintensity on DWI (27/30, 90%) (p=0.001). In all 10 hypervascular benign conditions, there was no venous washout on dynamic MRI and no sustained hyperintensity on DWI. Sensitivity and specificity for diagnosis of hypervascular HCCs were 92.9% and 100% in DWI and 72% and 100% in dynamic MRI, respectively.

CONCLUSION: Compared with the venous washout during dynamic imaging, DWI provides more reliable information in the MRI assessment of small hypervascular HCCs, distinguishing them from atypical hypervascular benign or pseudolesions. DWI could complement the early diagnosis of small hypervascular HCCs that do not display venous washout during dynamic imaging.
Files in This Item:
T201203192.pdf Download
DOI
22573299
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Radiology (영상의학교실) > 1. Journal Papers
Yonsei Authors
Kim, Ki Whang(김기황)
Kim, Dae Jung(김대중)
Kim, Joo Hee(김주희) ORCID logo https://orcid.org/0000-0001-5383-3602
Yu, Jeong Sik(유정식) ORCID logo https://orcid.org/0000-0002-8171-5838
Chung, Jae Joon(정재준) ORCID logo https://orcid.org/0000-0002-7447-1193
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/89834
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