Department of Radiology, Korea University Guro Hospital, Korea University College of Medicine, Seoul 152-703, Korea.
Magn Reson Imaging. 2011 Jan;29(1):83-90. doi: 10.1016/j.mri.2010.07.019. Epub 2010 Sep 15.
To describe the paradoxical high signal intensity of hepatocellular carcinoma (HCC) in the hepatobiliary phase on gadolinium-ethoxybenzyl-diethylenetriamine pentaacetic acid (Gd-EOB-DTPA)-enhanced magnetic resonance imaging (MRI).
A database search was performed to identify cases of HCC that showed unusual prolonged enhancement in the hepatobiliary phase of Gd-EOB-DTPA MRI. All patients received 3.0-T liver MRI including precontrast T1-weighted images, T2-weighted images and a post Gd-EOB-DTPA-enhanced dynamic study. The signal intensity of HCC was measured at pre-enhanced, arterial, portal, delayed and hepatobiliary phase using regions of interest. Radiologic and pathologic correlation was performed for the paradoxically prolonged enhancing portion of HCC in the hepatobiliary phase.
Four patients (all male, age range 44-70; mean 57.5 years) were included in this study. All patients showed HCC lesions that were low signal intensity (SI) on T1-WI, high SI on T2-WI, enhanced in arterial phase, and washed-out in delayed phase. All cases showed paradoxically high SI in hepatobiliary phase, which was unusual for HCC. Pathologically, they were all diagnosed as well-differentiated HCC with prominent cytoplasm and a bile secreting appearance.
HCC may demonstrate the prolonged high signal intensity at the hepatobiliary phase on Gd-EOB-DTPA enhanced MRI. These HCCs tended to be highly differentiated and to have prominent bile secretion.
描述钆塞酸二钠（Gd-EOB-DTPA）增强磁共振成像（MRI）肝胆期肝细胞癌（HCC）的反常高信号强度。
通过数据库检索，确定了在 Gd-EOB-DTPA MRI 肝胆期显示异常延长强化的 HCC 病例。所有患者均接受了 3.0T 肝脏 MRI 检查，包括平扫 T1 加权像、T2 加权像和 Gd-EOB-DTPA 增强动态研究。使用感兴趣区测量 HCC 的平扫、动脉期、门脉期、延迟期和肝胆期的信号强度。对肝胆期 HCC 中反常延长强化部分进行了影像学和病理学相关性分析。
本研究共纳入 4 例患者（均为男性，年龄 44-70 岁；平均 57.5 岁）。所有患者的 HCC 病变在 T1-WI 上呈低信号强度（SI），在 T2-WI 上呈高 SI，在动脉期增强，在延迟期洗脱。所有病例在肝胆期均表现出反常的高 SI，这对 HCC 来说并不常见。病理上，均诊断为高分化 HCC，细胞质明显，具有胆汁分泌外观。
在 Gd-EOB-DTPA 增强 MRI 上，HCC 可能在肝胆期显示延长的高信号强度。这些 HCC 往往分化良好，具有明显的胆汁分泌功能。
