Detection of Hepatocelluar Carcinoma in MR Arterial Portography; Diagnostic Significance as a Pre-Operative Evaluation

Yu, Jeong Sik; Kim, Ki Whang; Kim, Eun Kyung; Chung, Soo Yoon; Lee, Ho Chul; Jo, Byung June; Chon, Chae Yoon; Lee, Kwan Sik; Chi, Hoon Sang

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 patients suffering 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 the superior mesenteric or splenic artery during the T1-weighted FLASH sequence. The pathologic findings of surgical specimen or follow-up lipiodol CT findings were compared with the MR imaging.
RESULTS
MR arterial portography depicted 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 arterial portography showed perfusion defects from two cysts, one hemangioma, one inflammatory mass, and innumerable tiny regenerating nodules. Static T1-and T2-weighted imaging clearly differentiated, however, benign lesions and true hepatocellular carcinoma.
CONCLUSION
MR arterial portography combined with other fast MR imaging allows tissue characterization as well as high detection rate in the evaluation of hepatocellular carcinoma complicated with cirrhosis.