Gd-EOB-DTPA-enhanced magnetic resonance images of hepatocellular carcinoma: correlation with histological grading and portal blood flow.
OBJECTIVE
To retrospectively investigate enhancement patterns of hepatocellular carcinoma (HCC) and dysplastic nodule (DN) in the hepatobiliary phase of gadolinium-ethoxybenzyl-diethylenetriamine (Gd-EOB-DTPA)-enhanced MRI in relation to histological grading and portal blood flow.


METHODS
Sixty-nine consecutive patients with 83 histologically proven HCCs and DNs were studied. To assess Gd-EOB-DTPA uptake, we calculated the EOB enhancement ratio, which is the ratio of the relative intensity of tumorous lesion to surrounding nontumorous area on hepatobiliary phase images (post-contrast EOB ratio) to that on unenhanced images (pre-contrast EOB ratio). Portal blood flow was evaluated by CT during arterial portography.


RESULTS
Post-contrast EOB ratios significantly decreased as the degree of differentiation declined in DNs (1.00 ± 0.14) and well, moderately and poorly differentiated HCCs (0.79 ± 0.19, 0.60 ± 0.27, 0.49 ± 0.10 respectively). Gd-EOB-DTPA uptake, assessed by EOB enhancement ratios, deceased slightly in DNs and still more in HCCs, while there was no statistical difference in the decrease between different histological grades of HCC. Reductions in portal blood flow were observed less frequently than decreases in Gd-EOB-DTPA uptake in DNs and well-differentiated HCCs.


CONCLUSIONS
Reduced Gd-EOB-DTPA uptake might be an early event of hepatocarcinogenesis, preceding portal blood flow reduction. The hepatobiliary phase of Gd-EOB-DTPA-enhanced MRI may help estimate histological grading, although difficulties exist in differentiating HCCs from DNs.
Kogita
Sachiyo
S
Department of Gastroenterology, Ikeda Municipal Hospital, 3-1-18, Johnan, Ikeda, Osaka, 563-8510, Japan.
Imai
Yasuharu
Y
Okada
Masahiro
M
Kim
Tonsok
T
Onishi
Hiromitsu
H
Takamura
Manabu
M
Fukuda
Kazuto
K
Igura
Takumi
T
Sawai
Yoshiyuki
Y
Morimoto
Osakuni
O
Hori
Masatoshi
M
Nagano
Hiroaki
H
Wakasa
Kenichi
K
Hayashi
Norio
N
Murakami
Takamichi
T
D000368:Aged; D000369:Aged, 80 and over; D006528:Carcinoma, Hepatocellular / Q000175:diagnosis / Q000378:metabolism*; D003287:Contrast Media / Q000494:pharmacology*; D003952:Diagnostic Imaging / Q000379:methods; D005260:Female; D019786:Gadolinium DTPA / Q000494:pharmacology*; D006801:Humans; D008113:Liver Neoplasms / Q000175:diagnosis / Q000378:metabolism*; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008495:Medical Oncology / Q000379:methods; D008875:Middle Aged; D011169:Portal Vein / Q000473:pathology; D012189:Retrospective Studies
D003287:Contrast Media; C073590:gadolinium ethoxybenzyl DTPA; D019786:Gadolinium DTPA