Hepatocellular carcinoma: evaluation with dynamic and static gadobenate dimeglumine-enhanced MR imaging and histopathologic correlation.
OBJECTIVE
To analyze the potential of gadobenate dimeglumine-enhanced magnetic resonance (MR) imaging for the characterization and diagnosis of hepatocellular carcinoma (HCC) by using static and dynamic sequences.


METHODS
Twenty-eight patients with histopathologically proved HCC were evaluated with T1- and T2-weighted spin-echo and static and dynamic gradient-echo sequences before, during, and after intravenous administration of 0.1 mmol/kg gadobenate dimeglumine (0.5 mol/L).


RESULTS
During the perfusion phase of the dynamic sequence, all 16 nodular well-differentiated HCC lesions showed a rapid increase in signal intensity 10-30 seconds after injection followed by a progressive decrease in signal intensity. The nine poorly differentiated HCC lesions showed no rapid increase in signal intensity. All eight large (> 3 cm), nodular, well-differentiated HCC lesions showed a hypointense rim before injection and both hypo- and hyperintense rims (double-ring sign) immediately after injection, compared with normal liver parenchyma. About 55 seconds after injection, substantial single-rim enhancement was detected in 21 of the 28 HCC lesions.


CONCLUSIONS
Dynamic gadobenate dimeglumine-enhanced MR imaging allows improved characterization of HCC lesions, which show rapid increase in signal intensity during the early, arterial phase in well-differentiated HCC lesions and a double-ring sign in large well-differentiated nodular HCC lesions.
Vogl
T J
TJ
Department of Radiology, Rudolf Virchow Clinic, Humboldt-University of Berlin, Rudolf Virchow Hospital, Germany.
Stupavsky
A
A
Pegios
W
W
Hammerstingl
R
R
Mack
M
M
Diebold
T
T
Lodemann
K P
KP
Neuhaus
P
P
Felix
R
R
D006528:Carcinoma, Hepatocellular / Q000175:diagnosis*; D003287:Contrast Media; D004311:Double-Blind Method; D005260:Female; D005682:Gadolinium; D006801:Humans; D008099:Liver / Q000473:pathology*; D008113:Liver Neoplasms / Q000175:diagnosis*; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008536:Meglumine / Q000031:analogs & derivatives*; D008875:Middle Aged; D009942:Organometallic Compounds; D011446:Prospective Studies; D013997:Time Factors
D003287:Contrast Media; D009942:Organometallic Compounds; C064572:gadobenic acid; D008536:Meglumine; D005682:Gadolinium