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Gd-EOB-DTPA-enhanced magnetic resonance images of hepatocellular carcinoma: correlation with histological grading and portal blood flow

  • Hepatobiliary-Pancreas
  • Published:
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Abstract

Objective:

To retrospectively investigate enhancement patterns of hepatocellular carcinoma (HCC) and dysplastic nodule (DN) in the hepatobiliary phase of gadolinium-ethoxybenzyl-diethylenetriamine (Gd-EOB-DTPA)-enhanced MRI in relation to histological grading and portal blood flow.

Methods:

Sixty-nine consecutive patients with 83 histologically proven HCCs and DNs were studied. To assess Gd-EOB-DTPA uptake, we calculated the EOB enhancement ratio, which is the ratio of the relative intensity of tumorous lesion to surrounding nontumorous area on hepatobiliary phase images (post-contrast EOB ratio) to that on unenhanced images (pre-contrast EOB ratio). Portal blood flow was evaluated by CT during arterial portography.

Results:

Post-contrast EOB ratios significantly decreased as the degree of differentiation declined in DNs (1.00 ± 0.14) and well, moderately and poorly differentiated HCCs (0.79 ± 0.19, 0.60 ± 0.27, 0.49 ± 0.10 respectively). Gd-EOB-DTPA uptake, assessed by EOB enhancement ratios, deceased slightly in DNs and still more in HCCs, while there was no statistical difference in the decrease between different histological grades of HCC. Reductions in portal blood flow were observed less frequently than decreases in Gd-EOB-DTPA uptake in DNs and well-differentiated HCCs.

Conclusions:

Reduced Gd-EOB-DTPA uptake might be an early event of hepatocarcinogenesis, preceding portal blood flow reduction. The hepatobiliary phase of Gd-EOB-DTPA-enhanced MRI may help estimate histological grading, although difficulties exist in differentiating HCCs from DNs.

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Abbreviations

HCC:

Hepatocellular carcinoma

MDCT:

Multiphasic multidetector-row helical CT

Gd-EOB-DTPA:

Gadolinium-ethoxybenzyl-diethylenetriamine

CTAP:

Computed tomography during arterial portography

CTHA:

CT hepatic arteriography

GRE:

Gradient echo

LAVA:

Liver acquisition with volume acceleration

SPIO:

Superparamagnetic iron oxide

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Authors and Affiliations

  1. Department of Gastroenterology, Ikeda Municipal Hospital, 3-1-18, Johnan, Ikeda, Osaka, 563-8510, Japan

    Sachiyo Kogita, Yasuharu Imai, Kazuto Fukuda, Takumi Igura & Yoshiyuki Sawai

  2. Department of Radiology, Kinki University School of Medicine, Osaka, Japan

    Masahiro Okada & Takamichi Murakami

  3. Department of Radiology, Osaka University Graduate School of Medicine, Osaka, Japan

    Tonsok Kim, Hiromitsu Onishi & Masatoshi Hori

  4. Department of Radiology, Ikeda Municipal Hospital, Osaka, Japan

    Manabu Takamura

  5. Department of Surgery, Ikeda Municipal Hospital, Osaka, Japan

    Osakuni Morimoto

  6. Department of Surgery, Osaka University Graduate School of Medicine, Osaka, Japan

    Hiroaki Nagano

  7. Department of Diagnostic Pathology, Osaka City University Graduate School of Medicine, Osaka, Japan

    Kenichi Wakasa

  8. Department of Gastroenterology and Hepatology, Osaka University Graduate School of Medicine, Osaka, Japan

    Norio Hayashi

Authors
  1. Sachiyo Kogita
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  2. Yasuharu Imai
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  3. Masahiro Okada
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  7. Kazuto Fukuda
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  8. Takumi Igura
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  11. Masatoshi Hori
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  12. Hiroaki Nagano
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  13. Kenichi Wakasa
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  14. Norio Hayashi
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  15. Takamichi Murakami
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Corresponding author

Correspondence to Yasuharu Imai.

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Kogita, S., Imai, Y., Okada, M. et al. Gd-EOB-DTPA-enhanced magnetic resonance images of hepatocellular carcinoma: correlation with histological grading and portal blood flow. Eur Radiol 20, 2405–2413 (2010). https://doi.org/10.1007/s00330-010-1812-9

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  • DOI: https://doi.org/10.1007/s00330-010-1812-9

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