Small hepatocellular carcinoma on magnetic resonance imaging. Relation of signal intensity to angiographic and clinicopathologic findings.
OBJECTIVE
The authors discuss the clinicopathologic features and angiographic vascularity of various signal intensity patterns on magnetic resonance (MR) imaging of small hepatocellular carcinomas (HCCs).


METHODS
Magnetic resonance images of 88 resected HCCs (< or = 3 cm) were obtained using T1- and T2-weighted spin-echo images and T1-weighted images after gadolinium (Gd)-DTPA administration. Images were compared with angiographic and histopathologic findings.


RESULTS
Forty HCCs (45%) were depicted on T1-weighted images, 51 (58%) on T2-weighted images, and 41 (49%) on T1-weighted images after Gd-DTPA administration. Overall, 64 (76%) were found on at least one image. On T1-weighted images, hyperintense HCCs histologically showed fatty metamorphosis and portal tracts within the tumor. On T2-weighted images, HCC hyperintensity correlated with expansive growth, peliotic change, and hypervascularity. By contrast, HCCs that were undetected or hypointense on T2-weighted images were well differentiated with replacing growth and portal tracts. On T1-weighted images after Gd-DTPA, hyperintense HCCs had peliotic change; undetected HCCs were well differentiated and hypovascular.


CONCLUSIONS
Histologic grade, vascularity, portal tracts and peliotic change correlate with MR signal intensity. For hyperintense HCCs on T1-weighted images and hypo- or isointense HCCs on T2-weighted images, treatment methods must be assigned with the consideration that HCCs may be receiving transsinusoidal and portal blood supplies.
Honda
H
H
Department of Radiology, Faculty of Medicine, Kyushu University, Fukuoka, Japan.
Kaneko
K
K
Maeda
T
T
Kuroiwa
T
T
Fukuya
T
T
Yoshimitsu
K
K
Irie
H
H
Aibe
H
H
Takenaka
K
K
Masuda
K
K
D000328:Adult; D000368:Aged; D000792:Angiography; D006528:Carcinoma, Hepatocellular / Q000098:blood supply / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000473:pathology; D003287:Contrast Media; D005260:Female; D005682:Gadolinium; D019786:Gadolinium DTPA; D006801:Humans; D008113:Liver Neoplasms / Q000098:blood supply / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000473:pathology; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D009942:Organometallic Compounds; D004369:Pentetic Acid / Q000031:analogs & derivatives
D003287:Contrast Media; D009942:Organometallic Compounds; D004369:Pentetic Acid; D005682:Gadolinium; D019786:Gadolinium DTPA