Yonsei Med J.  1999 Jun;40(3):248-255. 10.3349/ymj.1999.40.3.248.

Early homogeneously enhancing hemangioma versus hepatocellular carcinoma: differentiation using quantitative analysis of multiphasic dynamic magnetic resonance imaging

• Jeong MG
• Yu JS
• Kim KW
• Jo BJ
• Kim JK

• KMID: 711645
• DOI: http://doi.org/10.3349/ymj.1999.40.3.248

Abstract

The aim of this study was to determine the usefulness of quantitative analysis of multiphasic dynamic contrast-enhanced magnetic resonance (MR) imaging in differentiating early homogeneously enhancing hemangiomas from hepatocellular carcinomas (HCCs). Four-phased dynamic MR imaging at 10 sec (first phase of dynamic contrast-enhanced imaging, P1), 35 sec (second phase, P2), 60 sec (third phase, P3) and 300 sec (delay phase, P4) immediately after intravenous administration of 0.1 mmol/kg Gadolinium-DTPA was obtained with 1.5-T unit with breath-hold multisection FLASH (fast low angle-shot) sequence (TR/TE, 113-130 msec/4.1 msec; flip angle, 80 degrees). Thirty-three HCCs and 18 hemangiomas, homogeneously enhanced on P1, were included in the study. The images were evaluated quantitatively (SNR, signal-to-noise ratio; and CNR, contrast- to- noise ratio of lesions). Quantitatively, mean CNR was higher for hemangiomas than for HCCs on all phases, and the difference in CNRs between hemangioma and HCCs was statistically significant on P3 and P4 (p < 0.0001). When the cutoff for CNR was set at a value of 7.00 on P3 and 1.00 on P4, sensitivity, specificity and accuracy were 94.4%, 93.9%, and 94.1% on P3, and 94.4%, 81.8%, and 86.3% on P4, respectively. There was no statistically significant difference in SNRs between HCC and hemangioma. The differential diagnosis between early, homogeneously enhancing hemangiomas and HCCs was more confidently made with CNRs of lesions on P3 and P4 in dynamic contrast-enhanced MR imaging.

Keyword

Liver; MR liver neoplasms; diagnosis liver neoplasms; MR magnetic resonance (MR); contrast enhancement

MeSH Terms

Adult
Aged
Carcinoma, Hepatocellular/diagnosis*
Contrast Media
Diagnosis, Differential
Female
Hemangioma/diagnosis*
Human
Image Enhancement
Liver Neoplasms/diagnosis*
Magnetic Resonance Imaging/methods*
Male
Middle Age