Article Sidebar
Views PDF: 327
Imaging characteristics and values of MRI for diagnosis of hepatocellular carcinoma ≤ 3cm in cirrhotic patients
Main Article Content
Abstract
SUMMARY
Purpose: To describe the MR imaging features and to evaluate values of MRI for diangosis of hepatocellular carcinomas ≤ 3cm in cirrhotic patients.
Materials and methods: 35 patients with final diagnosis of hepatocellular carcinoma (HCC)≤ 3cm undergone MRI 1.5 Tesla at Radiology Departement (Bach MaiHospital) from August 2014 to July 2015.
Results: The average diameter was 21.14mm, all were solitary, most of tumor locate in right liver. Among 35 tumors detected: 100% was hyperintense on Diffusion; 97.1% hyperintense on T2W; on inphase T1W 11.4% hyperintense, 57.2% hypointense, 31.4% isointense; on outphase T1W 2.9% hyperintense, 82.8% hypointense, 14.3% isointense; 40% tumors have fatty content inside. After contrast gadolium injection, at the arterial phase 71.4% of tumors showed enhancement; at the portal phase 48.57% of tumors showed contrast wash out; at the late phase 68.6% of tumors had
contrast wash out and 68.6% of tumors had a rim enhancement. MRI dectected 100% of tumors and diagnosed 54.3% of tumors based on the characteristic arterial contrast enhancement and portal or late phase contrast washout. The combination of ≥3 or ≥4 morphological and hemodynamic signs could increase the diagnostic sensitivity to
91.4% and 60% respectively.
Conclusion: Among 35 HCCs ≤ 3cm in cirrhotic livers: 97.1% and 100% appeared hyperintense on T2W and Diffusion respectively, most tumors were hyposignal on outphase T1W, 40% had fatty content. After gadolium contrast injection, 71.4% tumors had arterial contrast enhancement, 68.6% tumors showed portal or
late contrast washout, 68.6% had rim enhancement. MRI detected 100% tumors and diagnosed 54.3% of all tumors.
Article Details
Keywords
Hepatocellular carcinoma, HCC, cirrhosis, MRI
References
1. J Ferlay, F Bray, D Forman, et al (2010). Estimates of worldwide burden of cancer in 2008: GLOBOCAN 2008. Int. J. Cancer, 127, 2893–2917.
2. M Sherman. J Bruix (2011). Management of Hepatocellular Carcinoma: An Update. HEPATOLOGY, Vol. 53 (No. 3), 1020-1023.
3. M Sherman, J Bruix, J. M. Llovet (2001). Clinical management of Hepatocellular Carcinoma. Conclusion
of Barcelona -2000 EASL conference. Journal of Hepatology, 35, 421-430.
4. Huỳnh Quanh Huy, Phạm Minh Thông (2013). Nghiên cứu đặc điểm hình ảnh và vai trò của cộng hưởng từ trong chẩn đoán ung thư biểu mô tế bào gan. Y học thực hành, 11, 3-6.
5. Y. Y. Jeong, D. G. Mitchell và T. Kamishima (2002). Small (< 20 mm) enhancing hepatic nodules seen on arterial phase MR imaging of the cirrhotic liver: clinical implications. American Journal of Roentgenology, 178 (6), 1327-1334.
6. B. I. Choi (1998). Hepatocarcinogenesis in Liver Cirrhosis: Imaging Diagnosis. J Korean Med Sci, 13, 103-116.
7. M. Jonathon, M. Willatt, H.K. Hussain et al (2008). MR Imaging of Hepatocellular Carcinoma in the Cirrhotic Liver: Challenges and Controversies. Radiology, 247 (2), 311-320.
8. M A-S. Khan, H. K. Hussain, T. D. Johnson, (2010). Value of Delayed Hypointensity and Delayed Enhancing Rim in Magnetic Resonance Imaging Diagnosis of Small Hepatocellular Carcinoma in the Cirrhotic Liver. JOURNAL OF MAGNETIC RESONANCE IMAGING, 32, 360–366
9. M.-L. Chen, X.-Y. Zhang, L.-P. Qi et al (2014). Diffusion-weighted images (DWI) without ADC values in assessment of small focal nodules in cirrhotic liver. Chinese Journal of Cancer Research, 26 (1), 38.
10. O. Kazuhiko Ueda, Azusa Kitao (2014). Tumor hemodynamics and Hepatocarcinogenesis: Radio-Pathological Correlations and Outcomes of Carcinogenic Hepatocyte Nodules. ISRN Hepatology, Article ID 607628, 11p.
11. Y. Tang, Y. Yamashita, A. Arakawa et al (1999). Detection of hepatocellular carcinoma arising in cirrhotic livers: comparison of gadolinium-and ferumoxidesenhanced MR imaging. AJR. American journal of roentgenology, 172 (6), 1547-1554.
12. R. o. V. Alejandro Forner, Carmen Ayuso (2008). Diagnosis of Hepatic Nodules 20 mm or Smaller in Cirrhosis: Prospective Validation of the Noninvasive Diagnostic Criteria for Hepatocellular Carcinoma. HEPATOLOGY, 47 (97-104),
13. A. Sangiovanni, M. A. Manini, M. Iavarone et al (2010). The diagnostic and economic impact of contrast imaging techniques in the diagnosis of small hepatocellular carcinoma in cirrhosis. Gut, 59 (5), 638-644.
14. K. Khalili, T. K. Kim, H. J. Jang et al (2011). Optimization of imaging diagnosis of 1-2 cm hepatocellular carcinoma: an analysis of diagnostic performance and resource utilization. J Hepatol, 54 (4), 723-728.
15. J. Rimola, A. Forner, S. Tremosini et al (2012). Non-invasive diagnosis of hepatocellular carcinoma =2 cm in cirrhosis. Diagnostic accuracy assessing fat, capsule and signal intensity at dynamic MRI. J Hepatol, 56 (6), 1317-1323.
16. M. H RHEE, M-J KIM, M-S PAR, et al (2012). Differentiation of early hepatocellular carcinoma from
benign hepatocellular nodules on gadoxetic acid-enhanced
MRI. The British Journal of Radiology, 85 837–844.
17. Emilio Quaia, Riccardo Pizzolato (2013). Predictors of Dysplastic Nodule Diagnosis in Patients With Liver Cirrhosis on Unenhanced and Gadobenate Dimeglumine– Enhanced MRI With Dynamic and Hepatobiliary Phase. AJR, 200, 553–562.