Park Vivian Y, Choi Jin-Young, Chung Yong Eun, Kim Honsoul, Park Mi-Suk, Lim Joon Seok, Kim Ki Whang, Kim Myeong-Jin
Department of Radiology, Research Institute of Radiological Science, Yonsei University College of Medicine, Seoul, South Korea.
Liver Int. 2014 Nov;34(10):1593-602. doi: 10.1111/liv.12550. Epub 2014 Apr 10.
BACKGROUND & AIMS: The dynamic enhancement pattern of HCCs smaller than 3 cm in diameter on gadoxetic acid-enhanced magnetic resonance imaging (MRI) have not been extensively investigated. We aimed to evaluate the dynamic enhancement patterns of small HCCs (≤3 cm) on gadoxetic acid-enhanced magnetic resonance imaging (MRI) and compare enhancement patterns with multiphasic multidetector computed tomography (MDCT) based on tumour cellular differentiation and size.
We retrospectively included 55 patients with 67 surgically confirmed small HCCs (≤3 cm) who underwent multiphasic MDCT and gadoxetic acid-enhanced MRI. Dynamic enhancement patterns were analysed according to tumour cellular differentiation and size. Hepatobiliary phase images were also analysed to assess their additional value.
The proportion of small HCCs demonstrating the typical enhancement pattern differed depending on tumour cellular differentiation on both MRI (P = 0.001) and MDCT (P = 0.001), but differed depending on tumour size only on CT (P = 0.008). Gadoxetic acid-enhanced MRI more sensitively depicted the typical enhancement pattern than CT for all tumours (P = 0.001), for moderately or poorly differentiated HCCs (P = 0.021) and for HCCs ≤2 cm (P = 0.001). 80% of tumours with atypical enhancement could be diagnosed as HCC based on tumour size and hepatobiliary phase images.
On both gadoxetic acid-enhanced MRI and multiphasic CT, the dynamic enhancement patterns of small HCCs (≤3 cm) differed according to tumour cellular differentiation. Gadoxetic acid-enhanced MRI more frequently demonstrated the typical HCC enhancement pattern than CT in small HCCs.
钆塞酸二钠增强磁共振成像（MRI）对直径小于3 cm的肝细胞癌（HCC）动态强化模式的研究尚未广泛开展。我们旨在评估钆塞酸二钠增强磁共振成像（MRI）上小肝癌（≤3 cm）的动态强化模式，并根据肿瘤细胞分化程度和大小，将强化模式与多期多层螺旋计算机断层扫描（MDCT）进行比较。
我们回顾性纳入了55例经手术证实的小肝癌（≤3 cm）患者，共67个病灶，这些患者均接受了多期MDCT和钆塞酸二钠增强MRI检查。根据肿瘤细胞分化程度和大小分析动态强化模式。还对肝胆期图像进行分析，以评估其附加价值。
表现出典型强化模式的小肝癌比例在MRI（P = 0.001）和MDCT（P = 0.001）上均因肿瘤细胞分化程度而异，但仅在CT上因肿瘤大小而异（P = 0.008）。对于所有肿瘤（P = 0.001）、中低分化肝癌（P = 0.021）和直径≤2 cm的肝癌（P = 0.001），钆塞酸二钠增强MRI比CT更能敏感地显示典型强化模式。80%具有非典型强化的肿瘤可根据肿瘤大小和肝胆期图像诊断为肝癌。
在钆塞酸二钠增强MRI和多期CT上，小肝癌（≤3 cm）的动态强化模式均因肿瘤细胞分化程度而异。在小肝癌中，钆塞酸二钠增强MRI比CT更常显示典型的肝癌强化模式。
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