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

Kim SH, Lee WJ, Lim HK, Park CK - Korean J Radiol (2009)

Bottom Line: 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).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.

View Article: PubMed Central - PubMed

Affiliation: Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 135-710, Korea. kshyun@skku.edu

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.

Show MeSH

Related in: MedlinePlus

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.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
getmorefigures.php?uid=PMC2651447&req=5

Figure 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.

Mentions: The proportion of hyperintense HCCs according to the tumor size and five CT density patterns for well-differentiated HCCs are shown in Table 1. A total of 13 (15%) of 84 HCCs were not hyperintense as seen on SPIO-enhanced MR images (Figs. 3, 4). The proportion of hyperintense tumors for HCCs < 1 cm was less than for HCCs > 1 cm, but the difference was not statistically significant (p = 0.05). A chance to appear as a hyperintense HCC according to the five CT density patterns tended to increase from the isodense-isodense pattern to the hyperdense-hypodense pattern as shown in Table 1 (p < 0.001). Seventy (91%) of 77 HCCs that did not show the isodense-isodense pattern were hyperintense (Figs. 1, 2). Sixty-two (94%) of 66 hypervascular HCCs were hyperintense. In contrast, nine (50%) of 18 nonhypervascular HCCs were hyperintense. Twenty-three (68%) of 34 HCCs with an atypical enhancement pattern were hyperintense as seen on SPIO-enhanced MRI.


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

Kim SH, Lee WJ, Lim HK, Park CK - Korean J Radiol (2009)

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.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC2651447&req=5

Figure 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.
Mentions: The proportion of hyperintense HCCs according to the tumor size and five CT density patterns for well-differentiated HCCs are shown in Table 1. A total of 13 (15%) of 84 HCCs were not hyperintense as seen on SPIO-enhanced MR images (Figs. 3, 4). The proportion of hyperintense tumors for HCCs < 1 cm was less than for HCCs > 1 cm, but the difference was not statistically significant (p = 0.05). A chance to appear as a hyperintense HCC according to the five CT density patterns tended to increase from the isodense-isodense pattern to the hyperdense-hypodense pattern as shown in Table 1 (p < 0.001). Seventy (91%) of 77 HCCs that did not show the isodense-isodense pattern were hyperintense (Figs. 1, 2). Sixty-two (94%) of 66 hypervascular HCCs were hyperintense. In contrast, nine (50%) of 18 nonhypervascular HCCs were hyperintense. Twenty-three (68%) of 34 HCCs with an atypical enhancement pattern were hyperintense as seen on SPIO-enhanced MRI.

Bottom Line: 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).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.

View Article: PubMed Central - PubMed

Affiliation: Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 135-710, Korea. kshyun@skku.edu

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.

Show MeSH
Related in: MedlinePlus