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Pathology-MRI Correlation of Hepatocarcinogenesis: Recent Update.

Huh J, Kim KW, Kim J, Yu E - J Pathol Transl Med (2015)

Bottom Line: Understanding the important alterations during hepatocarcinogenesis as well as the characteristic magnetic resonance imaging (MRI) and histopathological features will be helpful for managing patients with chronic liver disease and hepatocellular carcinoma.Recent advances in MRI techniques, such as fat/iron quantification, diffusion-weighted images, and gadoxetic acid-enhanced MRI, have greatly enhanced our understanding of hepatocarcinogenesis.

View Article: PubMed Central - PubMed

Affiliation: Department of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.

ABSTRACT
Understanding the important alterations during hepatocarcinogenesis as well as the characteristic magnetic resonance imaging (MRI) and histopathological features will be helpful for managing patients with chronic liver disease and hepatocellular carcinoma. Recent advances in MRI techniques, such as fat/iron quantification, diffusion-weighted images, and gadoxetic acid-enhanced MRI, have greatly enhanced our understanding of hepatocarcinogenesis.

No MeSH data available.


Related in: MedlinePlus

Routine magnetic resonance imaging sequences. (A) T2-weighted imaging is helpful for the differential diagnosis of liver tumors. Hepatocellular carcinoma (HCC) usually shows intermediate high-signal intensity (arrowheads on the left), whereas hepatic cysts show bright high-signal intensity (arrow on the right). (B) In-phase and opposed-phase images provide information regarding the fat or iron content of hepatocellular nodules. The fat component of a nodule is seen as high-signal intensity on in-phase imaging (arrowhead on the left) and as low-signal intensity on opposed-phase imaging (arrow on the middle). On histology of the resected specimen, the nodule is confirmed as a fat-containing HCC. (C) Multiphasic dynamic images and hepatobiliary-phase images. After contrast injection, T1-weighted images are obtained in the arterial phase (AP), portal-venous phase (PVP), three-minute, delayed equilibrium phase (EP), and 20-minute, delayed hepatobiliary phase (HBP) to provide hemodynamic information regarding liver tumors. An HCC (arrowheads) shows typical hemodynamic features, including enhancement on AP, and washout on PVP and EP. On HBP, the HCC is seen as a hypodense mass. (D) Diffusion-weighted imaging (DWI) and the apparent diffusion coefficient (ADC) map are helpful for evaluating the cellularity of a liver tumor. HCC mostly shows high signal intensity on DWI (arrow on the left) and low signal on the ADC map (arrowheads on the right).
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f3-jptm-49-3-218: Routine magnetic resonance imaging sequences. (A) T2-weighted imaging is helpful for the differential diagnosis of liver tumors. Hepatocellular carcinoma (HCC) usually shows intermediate high-signal intensity (arrowheads on the left), whereas hepatic cysts show bright high-signal intensity (arrow on the right). (B) In-phase and opposed-phase images provide information regarding the fat or iron content of hepatocellular nodules. The fat component of a nodule is seen as high-signal intensity on in-phase imaging (arrowhead on the left) and as low-signal intensity on opposed-phase imaging (arrow on the middle). On histology of the resected specimen, the nodule is confirmed as a fat-containing HCC. (C) Multiphasic dynamic images and hepatobiliary-phase images. After contrast injection, T1-weighted images are obtained in the arterial phase (AP), portal-venous phase (PVP), three-minute, delayed equilibrium phase (EP), and 20-minute, delayed hepatobiliary phase (HBP) to provide hemodynamic information regarding liver tumors. An HCC (arrowheads) shows typical hemodynamic features, including enhancement on AP, and washout on PVP and EP. On HBP, the HCC is seen as a hypodense mass. (D) Diffusion-weighted imaging (DWI) and the apparent diffusion coefficient (ADC) map are helpful for evaluating the cellularity of a liver tumor. HCC mostly shows high signal intensity on DWI (arrow on the left) and low signal on the ADC map (arrowheads on the right).

Mentions: Nonradiologist physicians may not be familiar with MRI sequences and the information that can be obtained from those sequences. Indeed, there are many sequences of liver MRI which may cause confusion. In addition, the interpretation of MRI largely depends on which contrast agent is used. We summarize the commonly used sequences in Table 2 and illustrate the representative images of such sequences in Fig. 3.


Pathology-MRI Correlation of Hepatocarcinogenesis: Recent Update.

Huh J, Kim KW, Kim J, Yu E - J Pathol Transl Med (2015)

Routine magnetic resonance imaging sequences. (A) T2-weighted imaging is helpful for the differential diagnosis of liver tumors. Hepatocellular carcinoma (HCC) usually shows intermediate high-signal intensity (arrowheads on the left), whereas hepatic cysts show bright high-signal intensity (arrow on the right). (B) In-phase and opposed-phase images provide information regarding the fat or iron content of hepatocellular nodules. The fat component of a nodule is seen as high-signal intensity on in-phase imaging (arrowhead on the left) and as low-signal intensity on opposed-phase imaging (arrow on the middle). On histology of the resected specimen, the nodule is confirmed as a fat-containing HCC. (C) Multiphasic dynamic images and hepatobiliary-phase images. After contrast injection, T1-weighted images are obtained in the arterial phase (AP), portal-venous phase (PVP), three-minute, delayed equilibrium phase (EP), and 20-minute, delayed hepatobiliary phase (HBP) to provide hemodynamic information regarding liver tumors. An HCC (arrowheads) shows typical hemodynamic features, including enhancement on AP, and washout on PVP and EP. On HBP, the HCC is seen as a hypodense mass. (D) Diffusion-weighted imaging (DWI) and the apparent diffusion coefficient (ADC) map are helpful for evaluating the cellularity of a liver tumor. HCC mostly shows high signal intensity on DWI (arrow on the left) and low signal on the ADC map (arrowheads on the right).
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4440933&req=5

f3-jptm-49-3-218: Routine magnetic resonance imaging sequences. (A) T2-weighted imaging is helpful for the differential diagnosis of liver tumors. Hepatocellular carcinoma (HCC) usually shows intermediate high-signal intensity (arrowheads on the left), whereas hepatic cysts show bright high-signal intensity (arrow on the right). (B) In-phase and opposed-phase images provide information regarding the fat or iron content of hepatocellular nodules. The fat component of a nodule is seen as high-signal intensity on in-phase imaging (arrowhead on the left) and as low-signal intensity on opposed-phase imaging (arrow on the middle). On histology of the resected specimen, the nodule is confirmed as a fat-containing HCC. (C) Multiphasic dynamic images and hepatobiliary-phase images. After contrast injection, T1-weighted images are obtained in the arterial phase (AP), portal-venous phase (PVP), three-minute, delayed equilibrium phase (EP), and 20-minute, delayed hepatobiliary phase (HBP) to provide hemodynamic information regarding liver tumors. An HCC (arrowheads) shows typical hemodynamic features, including enhancement on AP, and washout on PVP and EP. On HBP, the HCC is seen as a hypodense mass. (D) Diffusion-weighted imaging (DWI) and the apparent diffusion coefficient (ADC) map are helpful for evaluating the cellularity of a liver tumor. HCC mostly shows high signal intensity on DWI (arrow on the left) and low signal on the ADC map (arrowheads on the right).
Mentions: Nonradiologist physicians may not be familiar with MRI sequences and the information that can be obtained from those sequences. Indeed, there are many sequences of liver MRI which may cause confusion. In addition, the interpretation of MRI largely depends on which contrast agent is used. We summarize the commonly used sequences in Table 2 and illustrate the representative images of such sequences in Fig. 3.

Bottom Line: Understanding the important alterations during hepatocarcinogenesis as well as the characteristic magnetic resonance imaging (MRI) and histopathological features will be helpful for managing patients with chronic liver disease and hepatocellular carcinoma.Recent advances in MRI techniques, such as fat/iron quantification, diffusion-weighted images, and gadoxetic acid-enhanced MRI, have greatly enhanced our understanding of hepatocarcinogenesis.

View Article: PubMed Central - PubMed

Affiliation: Department of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.

ABSTRACT
Understanding the important alterations during hepatocarcinogenesis as well as the characteristic magnetic resonance imaging (MRI) and histopathological features will be helpful for managing patients with chronic liver disease and hepatocellular carcinoma. Recent advances in MRI techniques, such as fat/iron quantification, diffusion-weighted images, and gadoxetic acid-enhanced MRI, have greatly enhanced our understanding of hepatocarcinogenesis.

No MeSH data available.


Related in: MedlinePlus