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. 2009 Mar-Apr;10(2):112-20.
doi: 10.3348/kjr.2009.10.2.112. Epub 2009 Mar 3.

SPIO-enhanced MRI findings of well-differentiated hepatocellular carcinomas: correlation with MDCT findings

Seong Hyun Kim  1 , Won Jae Lee, Hyo K Lim, Cheol Keun Park
Affiliations

SPIO-enhanced MRI findings of well-differentiated hepatocellular carcinomas: correlation with MDCT findings

Seong Hyun Kim et al. Korean J Radiol. 2009 Mar-Apr.

Abstract

Objective: This study was designed to assess superparamagnetic iron oxide (SPIO)-enhanced MRI findings of well-differentiated hepatocellular carcinomas (HCCs) correlated with their multidetector-row CT (MDCT) findings.

Materials and methods: Seventy-two patients with 84 pathologically proven well-differentiated HCCs underwent triple-phase MDCT and SPIO-enhanced MRI at a magnetic field strength of 1.5 Tesla (n = 49) and 3.0 Tesla (n = 23). Two radiologists in consensus retrospectively reviewed the CT and MR images for attenuation value and the signal intensity of each tumor. The proportion of hyperintense HCCs as depicted on SPIO-enhanced T2- or T2(*)-weighted images were compared in terms of tumor size (< 1 cm and > 1 cm), five CT attenuation patterns based on arterial and equilibrium phases and magnetic field strength, by the use of univariate and multivariate analyses.

Results: Seventy-eight (93%) and 71 (85%) HCCs were identified by CT and on SPIO-enhanced T2- and T2(*)-weighted images, respectively. For the CT attenuation pattern, one (14%) of seven isodense-isodense, four (67%) of six hypodense-hypodense, four (80%) of five isodense-hypodense, 14 (88%) of 16 hyperdense-isodense and 48 (96%) of 50 hyperdense-hypodense HCCs were hyperintense (Cochran-Armitage test for trend, p < 0.001). Based on the use of multivariate analysis, the CT attenuation pattern was the only factor that affected the proportion of hyperintense HCCs as depicted on SPIO-enhanced T2- or T2(*)-weighted images (p < 0.001). Tumor size or magnetic field strength was not a factor that affected the proportion of hyperintense HCCs based on the use of univariate and multivariate analysis (p > 0.05).

Conclusion: Most well-differentiated HCCs show hyperintensity on SPIO-enhanced MRI, although the lesions show various CT attenuation patterns. The CT attenuation pattern is the main factor that affects the proportion of hyperintense well-differentiated HCCs as depicted on SPIO-enhanced MRI.

Keywords: Superparamagnetic iron oxide-enhanced MRI, MDCT; Well-differentiated hepatocellular carcinoma.

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Figures

Fig. 1
Fig. 1
61-year-old woman with 0.5-cm well-differentiated hepatocellular carcinoma in segment VII. A, B. Contrast-enhanced CT scans obtained at arterial (A) and equilibrium (B) phases show small nodule with hypodense-hypodense pattern (arrows), which mimics nonmalignant nodule such as regenerative or dysplastic nodule. Small hypodense lesion (arrowhead in B) in left liver is part of cyst. C. Ferucarbotran-enhanced T2*-weighted fast field-echo (TR/TE, 129/9.2 msec; flip angle, 20°) axial image obtained at 3.0 T shows small hyperintense nodule (arrow). Small hyperintense lesion (arrowhead) in left liver is part of cyst.
Fig. 2
Fig. 2
57-year-old man with 1.9-cm well-differentiated hepatocellular carcinoma in segment V. A, B. Contrast-enhanced CT scans obtained at arterial (A) and equilibrium (B) phases show small nodule with isodense-hypodense pattern (arrows). C. Ferucarbotran-enhanced T2*-weighted fast field-echo (TR/TE, 129/9.2 msec; flip angle, 20°) axial image obtained at 3.0 T shows discrete hyperintense nodule (arrow).
Fig. 3
Fig. 3
48-year-old man with 2.3-cm well-differentiated hepatocellular carcinoma in segment VI. A, B. Contrast-enhanced CT scans obtained at arterial (A) and equilibrium (B) phases show nodule with hyperdense-isodense pattern (arrows). C. As seen on ferucarbotran-enhanced T2*-weighted fast multiplanar gradient-recalled echo axial image (TR/TE range, 130/8.4 msec; flip angle, 30°) obtained at 1.5 T, nodule as seen on CT image does not appear to be hyperintense.
Fig. 4
Fig. 4
64-year-old man with 1.6-cm well-differentiated hepatocellular carcinoma in segment VI. A, B. Contrast-enhanced CT scans obtained at arterial (A) and equilibrium (B) phases show small nodule with hyperdense-hypodense pattern (arrows). C. As seen on ferucarbotran-enhanced T2*-weighted fast multiplanar gradient-recalled echo axial image (TR/TE range, 130/8.4 msec; flip angle, 30°) obtained at 1.5 T, nodule as seen on CT image does not appear to be hyperintense.
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