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 Kogita
  • Yasuharu Imai
  • Masahiro Okada
  • Tonsok Kim
  • Hiromitsu Onishi
  • Manabu Takamura
  • Kazuto Fukuda
  • Takumi Igura
  • Yoshiyuki Sawai
  • Osakuni Morimoto
  • Masatoshi Hori
  • Hiroaki Nagano
  • Kenichi Wakasa
  • Norio Hayashi
  • Takamichi Murakami
Hepatobiliary-Pancreas

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 

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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Copyright information

© European Society of Radiology 2010

Authors and Affiliations

  • Sachiyo Kogita
    • 1
  • Yasuharu Imai
    • 1
  • Masahiro Okada
    • 2
  • Tonsok Kim
    • 3
  • Hiromitsu Onishi
    • 3
  • Manabu Takamura
    • 4
  • Kazuto Fukuda
    • 1
  • Takumi Igura
    • 1
  • Yoshiyuki Sawai
    • 1
  • Osakuni Morimoto
    • 5
  • Masatoshi Hori
    • 3
  • Hiroaki Nagano
    • 6
  • Kenichi Wakasa
    • 7
  • Norio Hayashi
    • 8
  • Takamichi Murakami
    • 2
  1. 1.Department of GastroenterologyIkeda Municipal HospitalOsakaJapan
  2. 2.Department of RadiologyKinki University School of MedicineOsakaJapan
  3. 3.Department of RadiologyOsaka University Graduate School of MedicineOsakaJapan
  4. 4.Department of RadiologyIkeda Municipal HospitalOsakaJapan
  5. 5.Department of SurgeryIkeda Municipal HospitalOsakaJapan
  6. 6.Department of SurgeryOsaka University Graduate School of MedicineOsakaJapan
  7. 7.Department of Diagnostic PathologyOsaka City University Graduate School of MedicineOsakaJapan
  8. 8.Department of Gastroenterology and HepatologyOsaka University Graduate School of MedicineOsakaJapan

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