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Hepatocellular carcinoma 20 mm or smaller in cirrhosis patients: early magnetic resonance enhancement by gadoxetic acid compared with gadopentetate dimeglumine

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Abstract

Purpose

To evaluate the differences in enhancement pattern of hepatocellular carcinoma (HCC) 20 mm or smaller and enhancement effects of hepatic vessels on early dynamic contrast-enhanced magnetic resonance imaging (MRI) obtained with gadoxetic acid and gadopentetate dimeglumine in the same patients with cirrhosis.

Methods

We reviewed MR images using gadoxetic acid and gadopentetate dimeglumine in the same 34 patients with 42 histologically confirmed HCCs (median diameter, 14.5 mm). The percentage enhancements (PEs) of HCC, the hepatic artery and portal vein and relative contrasts (RCs) between HCC and the liver were calculated and analyzed statistically.

Results

The PEs of HCC, the hepatic artery and portal vein were significantly lower for gadoxetic acid in comparison with gadopentetate dimeglumine in the arterial phase (p = 0.0256 for HCC, p < 0.0001 for hepatic artery) and portal phase (p < 0.0001 for HCC, portal vein). The RC between HCC and the liver was significantly lower for gadoxetic acid in comparison with gadopentetate dimeglumine in the arterial phase (p = 0.0422), but was not significantly different in the portal phase (p = 0.1133). Forty-one of the 42 (97.62 %) nodules showed arterial hypervascularization. Of these, 31 (75.61 %) nodules were hypointense in the portal phase for gadoxetic acid, and 22 (53.66 %) were hypointense for gadopentetate dimeglumine (p = 0.038).

Conclusions

Compared with gadopentetate dimeglumine, gadoxetic acid-enhanced MRI demonstrated a different enhancement pattern of inferior arterial enhancement and was more rapidly hypointense in the portal phase for HCC. It showed markedly lower enhancement for hepatic artery and portal vein in the patients with cirrhosis.

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Acknowledgements

This project was supported by the National Science Foundation for Young Scientists of China (Grant No. 81001025, to Sheng-Xiang Rao).

Conflict of interest

Cai-Zhong Chen, Sheng-Xiang Rao, Ying Ding, Shu-Jie Zhang, Feng Li, Qiang Gao, and Meng-Su Zeng declare that they have no conflict of interest.

Compliance with ethical requirements

The retrospective study was approved by the institutional review board of Zhongshan Hospital, Fudan University, and informed consent was waived.

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Authors and Affiliations

  1. Department of Radiology, Zhongshan Hospital, Fudan University, Shanghai, China

    Cai-Zhong Chen, Sheng-Xiang Rao, Ying Ding, Shu-Jie Zhang & Meng-Su Zeng

  2. Shanghai Medical Imaging Institute, 180 Fenglin Rd, Shanghai, 200032, China

    Cai-Zhong Chen, Sheng-Xiang Rao, Ying Ding, Shu-Jie Zhang & Meng-Su Zeng

  3. Department of Gastroenterology and Hepatology, Zhongshan Hospital, Fudan University, Shanghai, China

    Feng Li

  4. Liver Cancer Institute, Zhongshan Hospital, Fudan University, Shanghai, China

    Qiang Gao

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  1. Cai-Zhong Chen
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  2. Sheng-Xiang Rao
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  3. Ying Ding
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  4. Shu-Jie Zhang
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  5. Feng Li
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  7. Meng-Su Zeng
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Corresponding author

Correspondence to Sheng-Xiang Rao.

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Chen, CZ., Rao, SX., Ding, Y. et al. Hepatocellular carcinoma 20 mm or smaller in cirrhosis patients: early magnetic resonance enhancement by gadoxetic acid compared with gadopentetate dimeglumine. Hepatol Int 8, 104–111 (2014). https://doi.org/10.1007/s12072-013-9467-7

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  • DOI: https://doi.org/10.1007/s12072-013-9467-7

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