MR differentiation of hepatic haemangioma and hepatocellular carcinoma: value of delayed-phase Gd-DTPA enhanced images.

The efficacy of three different approaches (precontrast and delayed-phase postcontrast T1-weighted (T1-W) images, measurement of T2 value, and dynamic FLASH imaging) for differentiation between hepatic haemangiomas and hepatocellular carcinomas, was compared. Most haemangiomas (89%) showed iso- or hypointensity on precontrast T1-W images and hyperintensity on delayed-phase postcontrast T1-W images. By using both pre/postcontrast T1-W images and T2 measurement, 30 out of 32 lesions (94%) were correctly differentiated. The dynamic FLASH imaging did not significantly improve the overall accuracy although it played a critical role in a few problematic cases. It is concluded that the combination of pre/postcontrast T1-W images is a promising approach for differentiation of small hepatic tumours, and plays a complementary role with T2 measurement.