Ewha Med J.  2016 Oct;39(4):110-117. 10.12771/emj.2016.39.4.110.

MRI Findings of Lipiodol Uptake in Hepatocellular Carcinomas: A Focus on Signal Intensity

• Lee MJ
• Kim MJ
• Baek SY

• KMID: 2356382
• DOI: http://doi.org/10.12771/emj.2016.39.4.110

Abstract

OBJECTIVES
To evaluate MRI findings of non-recurrent hepatocellular carcinomas with lipiodol uptake (LHCCs) treated with transarterial chemoembolization.
METHODS
28 LHCCs were divided into two groups according to amount of lipiodol uptake and tumor size, retrospectively. According to amount of lipiodol uptake, HCCs were classified into group A with dense lipiodol uptake (more than 90%) and group B with partial lipiodol uptake (between 50% and 90%). For HCC size analysis, group I was defined by a longest diameter of less than 2 cm, and group II was defined by a longest diameter of greater than or equal to 2 cm.
RESULTS
In group A (n=16), eight LHCCs showed high signal intensity (SI) on T2-weighted images (T2WI), ten LHCCs showed low SI on T1-weighted imaged (T1WI), six LHCCs showed decreased SI at higher b value of diffusion-weighted images (DWI). In group B (n=12), six LHCCs revealed high SI on T2WI, six LHCCs revealed low SI on T1WI, ten LHCCs decreased SI at higher b value of DWI. As compared with tumor size and SI, six of 12 LHCCs in group I and eight of 16 LHCCs in group II showed high SI on T2WI. Six LHCCs in group I and ten LHCCs in group II showed low SI on T1WI. All LHCCs were not enhanced.
CONCLUSION
Signal intensities of LHCCs were variable, but more than half of LHCCs showed high SI on T2WI, low SI on T1WI, decreased SI at higher b value of DWI, regardless of lipiodol uptake or tumor size.

Keyword

Hepatocellular carcinoma; Magnetic resonance imaging; Transarterial chemoembolization; Signal intensity; Lipiodol

MeSH Terms

Carcinoma, Hepatocellular*
Ethiodized Oil*
Magnetic Resonance Imaging*
Retrospective Studies
Ethiodized Oil

Figure

• 

  Fig. 1 Hepatocellular carcinomas with lipiodol uptake on precontrast computed tomography with bone window setting. (A) The hepatocellular carcinoma (arrow) shows dense uptake of lipiodol in more than 90% of the area of the lesion in hepatic segment 6 and is classified into group A. (B) The hepatocellular carcinoma (arrow) reveals partial uptake of lipiodol in 50% to 90% of the area of the lesion in hepatic segment 5 and is classified into group B.

• 

  Fig. 2 MR images of a 69-year-old patient with a 1.9×1.3 cm-sized dense hepatocellular carcinoma with lipiodol uptake in hepatic segment 5. Hepatocellular carcinoma (arrows) shows dense uptake of lipiodol on precontrast computed tomography with bone window setting (A), high signal intensity on T2-weighted images (B), and low signal intensity on T1-weighted images (C). On diffusion-weighted images, it reveals high signal intensity at lower b factors (b=0 and b=50) (D and E, respectively) and decreased signal intensity at a higher b factor (b=800) (F). The lesion shows high signal intensity on in-phase gradient-echo images (G) and low signal intensity on out-of-phase gradient-echo images (H). It is not enhanced on dynamic contrast-enhanced arterial phase (I), portal phase (J) or 10-minute delayed phase (K) images.

• 

  Fig. 3 MR images of a 57-year-old patient with a 2.3×2.3 cm-sized hepatocellular carcinoma with partial lipiodol uptake in hepatic segment 6. Hepatocellular carcinoma (arrows) shows partial uptake of lipiodol on precontrast computed tomography with bone window setting (A), high signal intensity on T2-weighted images (B), and low signal intensity on T1-weighted images (C). On diffusion-weighted images, the lesion reveals high signal intensity at a lower b factor (b=0) (D) and decreased signal intensity at a higher b factor (b=800) (E) images. It shows low signal intensity on in-phase (F) and out-of-phase (G) gradient-echo images. Hepatocellular carcinomas is not enhanced on dynamic contrast-enhanced arterial phase (H), portal phase (I) or 20-minute delayed phase (J) images.

• 

  Fig. 4 MR images of a 73-year-old patient with a 0.7×0.6 cm-sized, small, hepatocellular carcinomas with dense lipiodol uptake in the hepatic segment 5. Hepatocellular carcinoma (arrows) shows dense uptake of lipiodol on precontrast computed tomography with bone window setting (A), low signal intensity on T2-weighted images (B) and T1-weighted images (C). Diffusion-weighted images reveals high signal intensity at a lower b factor (b=0) (D) and decreased signal intensity at a higher b factor (b=800) (E). Hepatocellular carcinoma with dense lipiodol uptake shows isointensity on in-phase gradient-echo images (F) and low signal intensity on out-of-phase gradient-echo images (G).

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