Lencioni R, Mascalchi M, Caramella D, Bartolozzi C
Department of Radiology, University of Pisa, Italy.
Abdom Imaging. 1996 Jan-Feb;21(1):41-8. doi: 10.1007/s002619900007.
To investigate the usefulness of color Doppler ultrasound (US) and dynamic Gd-DTPA-enhanced magnetic resonance (MR) imaging in the differentiation of small hepatocellular carcinoma (HCC) and adenomatous hyperplasia (AH).
Thirty-eight small (3 cm or less) nodular lesions (in 38 cirrhotic patients) with US features consistent with HCC underwent evaluation with color Doppler US and MR imaging. Breath-hold T1-weighted rapid acquisition spin echo MR sequence after bolus injection of 0.1 mmol/kg gadopentetate dimeglumine was used to evaluate dynamic enhancement. US-guided tissue-core percutaneous biopsy established the diagnosis: HCC in 28 cases and AH in 10.
Color signals with pulsatile or continuous Doppler spectrum were demonstrated in 19 of 28 HCCs (68%) but in none of the AHs. Although there was considerable overlap in signal intensity between HCC and AH on both unenhanced T1- and T2-weighted images, early enhancement on breath-hold T1-weighted images obtained 40 s after starting contrast administration was observed in 22 of 28 HCCs (79%) but in none of the AHs. In 26 of 28 HCCs (93%), pulsatile or continuous flow at color Doppler US, early enhancement at dynamic MR imaging, or both were observed.
Findings with color Doppler US and dynamic Gd-DTPA-enhanced MR imaging enable a reliable distinction between small HCC and AH.
