Hepatobiliary-Pancreas

European Radiology

, Volume 20, Issue 10, pp 2405-2413

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

  • Sachiyo KogitaAffiliated withDepartment of Gastroenterology, Ikeda Municipal Hospital
  • , Yasuharu ImaiAffiliated withDepartment of Gastroenterology, Ikeda Municipal Hospital Email author 
  • , Masahiro OkadaAffiliated withDepartment of Radiology, Kinki University School of Medicine
  • , Tonsok KimAffiliated withDepartment of Radiology, Osaka University Graduate School of Medicine
  • , Hiromitsu OnishiAffiliated withDepartment of Radiology, Osaka University Graduate School of Medicine
  • , Manabu TakamuraAffiliated withDepartment of Radiology, Ikeda Municipal Hospital
  • , Kazuto FukudaAffiliated withDepartment of Gastroenterology, Ikeda Municipal Hospital
  • , Takumi IguraAffiliated withDepartment of Gastroenterology, Ikeda Municipal Hospital
  • , Yoshiyuki SawaiAffiliated withDepartment of Gastroenterology, Ikeda Municipal Hospital
    • , Osakuni MorimotoAffiliated withDepartment of Surgery, Ikeda Municipal Hospital
    • , Masatoshi HoriAffiliated withDepartment of Radiology, Osaka University Graduate School of Medicine
    • , Hiroaki NaganoAffiliated withDepartment of Surgery, Osaka University Graduate School of Medicine
    • , Kenichi WakasaAffiliated withDepartment of Diagnostic Pathology, Osaka City University Graduate School of Medicine
    • , Norio HayashiAffiliated withDepartment of Gastroenterology and Hepatology, Osaka University Graduate School of Medicine
    • , Takamichi MurakamiAffiliated withDepartment of Radiology, Kinki University School of Medicine

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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.

Keywords

Gd-EOB-DTPA-enhanced MR imaging Hepatocellular carcinoma Dysplastic nodule Histological grading Portal blood flow