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Imaging features of small hepatocellular carcinomas with microvascular invasion on gadoxetic acid-enhanced MR imaging.

 Myeong-Jin Kim  ;  Myungsu Lee  ;  Jin-Young Choi  ;  Young Nyun Park 
 EUROPEAN JOURNAL OF RADIOLOGY, Vol.81(10) : 2507-2512, 2012 
Journal Title
Issue Date
Carcinoma, Hepatocellular/complications ; Carcinoma, Hepatocellular/pathology* ; Contrast Media ; Female ; Gadolinium DTPA* ; Humans ; Liver Neoplasms/complications ; Liver Neoplasms/pathology* ; Magnetic Resonance Imaging/methods* ; Male ; Microvessels/pathology* ; Middle Aged ; Neoplasm Invasiveness ; Neovascularization, Pathologic/etiology ; Neovascularization, Pathologic/pathology* ; Reproducibility of Results ; Sensitivity and Specificity
Hepatocellular carcinoma ; Microvascular invasion ; Magnetic resonance imaging ; Contrast media ; Gadoxetic acid disodium (Gd-EOB-DTPA)
OBJECTIVES: Detection of hepatocellular carcinomas (HCCs) before microvascular invasion (MVI) occurs is important due to the poor outcomes associated with MVI. We retrospectively investigated the imaging features of small HCCs with MVI on gadoxetic acid-enhanced MR imaging. METHODS: Fifty patients (40 men and 10 women; mean age, 54 years) with 58 surgically proven small (2 cm or less) HCCs were evaluated by gadoxetic acid-enhanced MRI. Signal intensities on imaging sequences and the presence of the typical dynamic enhancement pattern (arterial enhancement and washout) were assessed. Fisher's exact tests were performed to evaluate the relationships between the presence of MVI, tumor size, and imaging findings. RESULTS: None of the 12 small HCCs with diameters of 1cm or less had MVI, while 15 (33%) of the 46 small HCCs with diameters of 1.1-2.0 cm had MVI (p=0.025, Fisher's exact test). Among the small HCCs with diameters of 1.1-2.0 cm, all HCCs with MVI showed the typical dynamic pattern and hyperintensity on T2- and diffusion-weighted images. Most HCCs (54 lesions, 93%) were hypointense on hepatobiliary phase images regardless of the presence of MVI. CONCLUSIONS: All small HCCs with MVI showed typical dynamic pattern and hyperintensity on T2-weighted and diffusion-weighted images, while atypical dynamic pattern and size of less than 1cm in diameter may suggest absence of MVI.
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1. College of Medicine (의과대학) > Dept. of Pathology (병리학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Radiology (영상의학교실) > 1. Journal Papers
Yonsei Authors
Kim, Myeong Jin(김명진) ORCID logo https://orcid.org/0000-0001-7949-5402
Park, Young Nyun(박영년) ORCID logo https://orcid.org/0000-0003-0357-7967
Lee, Myung Su(이명수)
Choi, Jin Young(최진영) ORCID logo https://orcid.org/0000-0002-9025-6274
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