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KMID : 0880420090100020112
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Korean Journal of Radiology
2009 Volume.10 No. 2 p.112 ~ p.120
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SPIO-Enhanced MRI Findings of Well-Differentiated Hepatocellular Carcinomas: Correlation with MDCT Findings
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Kim Seong-Hyun
Lee Won-Jae
Lim Hyo K.
Park Cheol Keun
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Abstract
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Objective : This study was designed to assess superparamagnetic iron oxide (SPIO)-enhanced MRI findings of well-differentiated hepatocellular carcinomas (HCCs) correlated with their multidetector-row CT (MDCT) findings.
Materials and Methods : Seventy-two patients with 84 pathologically proven well-differentiated HCCs underwent triple-phase MDCT and SPIO-enhanced MRI at a magnetic field strength of 1.5 Tesla (n = 49) and 3.0 Tesla (n = 23). Two radiologists in consensus retrospectively reviewed the CT and MR images for attenuation value and the signal intensity of each tumor. The proportion of hyperintense HCCs as depicted on SPIO-enhanced T2- or T2*-weighted images were compared in terms of tumor size (< 1 cm and > 1 cm), five CT attenuation patterns based on arterial and equilibrium phases and magnetic field strength, by the use of univariate and multivariate analyses.
Result : Seventy-eight (93%) and 71 (85%) HCCs were identified by CT and on SPIO-enhanced T2- and T2*-weighted images, respectively. For the CT attenuation pattern, one (14%) of seven isodense-isodense, four (67%) of six hypodense-hypodense, four (80%) of five isodense-hypodense, 14 (88%) of 16 hyperdense-isodense and 48 (96%) of 50 hyperdense-hypodense HCCs were hyperintense (Cochran-Armitage test for trend, p < 0.001). Based on the use of multivariate analysis, the CT attenuation pattern was the only factor that affected the proportion of hyperintense HCCs as depicted on SPIO-enhanced T2- or T2*-weighted images (p < 0.001). Tumor size or magnetic field strength was not a factor that affected the proportion of hyperintense HCCs based on the use of univariate and multivariate analysis (p > 0.05).
Conclusion : Most well differentiated HCCs showed hyperintensity on SPIO-enhanced MRI, although the lesions showed various CT attenuation patterns. The CT attenuation pattern was the main factor that affected the proportion of hyperintense well-differentiated HCCs as depicted on SPIO-enhanced MRI.
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KEYWORD
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Well-differentiated hepatocellular carcinoma, Superparamagnetic iron oxide-enhanced MRI, MDCT
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