Double arterial phase dynamic MRI with sensitivity encoding (SENSE) for hypervascular hepatocellular carcinomas.
OBJECTIVE
To investigate the efficacy of SENSE MRI, including the double arterial phase dynamic study, to detect hypervascular hepatocellular carcinomas (HCCs).


METHODS
MRI of the liver was performed in 40 consecutive patients (20 by conventional MRI and 20 by SENSE MRI). The SENSE technique was used to obtain breath-hold T1-weighted FSE images (TR/TE = 556/12 msec), respiratory-triggered T2-weighted FSE images (TR/TE = 1800/90 msec) with and without fat suppression, and dynamic MR images (TR/TE/FA = 160-168/4.6 msec/70 degrees ). In each arterial dominant phase and portal dominant phase, two scans were consecutively performed with one breath-hold, leading to the double arterial phase and double portal phase images with SENSE.


RESULTS
The sensitivity of SENSE MRI for HCCs diagnosed from all MR images, including dynamic study, T1-weighted images, and T2-weighted images, was 91.7%, while that of conventional MRI was 76.3%. The positive predictive value of SENSE MRI for HCCs was 91.7%, while that of conventional MRI was 87.9%. In terms of HCCs < or = 10 mm, the sensitivity and positive predictive values of SENSE MRI were 78.6% and 78.6%, respectively, while those of conventional MRI were 27.3% and 60.0%, respectively. The number of detected HCCs < or = 10 mm was significantly larger in SENSE MRI than in conventional MRI (P < 0.05). The cause of false-positive lesions on SENSE MR images was an arterioportal shunt.


CONCLUSIONS
SENSE MRI with double arterial phase dynamic study showed higher sensitivity compared to the conventional technique. Therefore, SENSE MRI is a promising method for the detection of HCC.
Department of Radiology, Institute of Clinical Medicine, University of Tsukuba, Tsukuba, Ibaraki, Japan. hir-yosh@md.tsukuba.ac.jp
Hiroshi
H
Yoshioka
Nobuyuki
N
Takahashi
Masayuki
M
Yamaguchi
Douqiang
D
Lou
Yukihisa
Y
Saida
Yuji
Y
Itai
D006528:Carcinoma, Hepatocellular / Q000098:blood supply* / Q000175:diagnosis; D005260:Female; D006801:Humans; D008099:Liver / Q000098:blood supply / Q000473:pathology; D008113:Liver Neoplasms / Q000098:blood supply* / Q000175:diagnosis; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D012680:Sensitivity and Specificity