Characterization of cirrhotic nodules with gadoxetic acid-enhanced magnetic resonance imaging: the efficacy of hepatocyte-phase imaging.
OBJECTIVE
To evaluate the efficacy of hepatocyte-phase imaging (HP) in characterization of focal hepatic lesions in cirrhotic liver using gadoxetic acid-enhanced magnetic resonance imaging (MRI).


METHODS
A total of 66 nodules of 38 patients with liver cirrhosis undergoing gadoxetic acid-enhanced MRI were prospectively enrolled in this study. The histological examination revealed 15 dysplastic nodules (DNs), 7 well-differentiated hepatocellular carcinomas (wHCCs), and 44 moderately differentiated HCCs (mHCCs). Two imaging sets (Set A without HP, Set B with HP) were prepared to evaluate the efficacy of HP in lesion characterization.


RESULTS
The mean enhancement ratios (ERs) of mHCC were significantly increased in arterial phase followed by a subsequent decreased in hepatocyte phases. The mean ERs of wHCC were increased in dynamic study and followed by a plateau in the hepatocyte phase. The mean ERs of DNs were increased in dynamic study and hepatocyte phase. The mean liver-to-lesion contrasts of mHCCs were increased in arterial phase and HP (P < 0.05). wHCCs were only increased in HP (P < 0.05). DNs showed no significant difference in any phase (P > 0.05). There were seven additional HCCs that were detected in HP using imaging Set B compared to Set A. The diagnostic performance of Set B was significantly higher than that of Set A (P = 0.016).


CONCLUSIONS
The combination of gadoxetic acid-enhanced dynamic study and hepatocyte-phase T1WI may provide better diagnostic performance than only dynamic study in characterization of focal lesions in cirrhotic liver.
Chou
Chen-Te
CT
Department of Biomedical Imaging and Radiological Science, National Yang-Ming Medical University, Taipei, Taiwan.
Chen
Yao-Li
YL
Su
Wei-Wen
WW
Wu
Hwa-Koon
HK
Chen
Ran-Chou
RC
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D006528:Carcinoma, Hepatocellular / Q000175:diagnosis* / Q000473:pathology; D002454:Cell Differentiation; D003287:Contrast Media / Q000494:pharmacology*; D005260:Female; D005355:Fibrosis / Q000175:diagnosis* / Q000473:pathology*; D019786:Gadolinium DTPA / Q000494:pharmacology*; D022781:Hepatocytes / Q000473:pathology*; D006801:Humans; D008099:Liver / Q000473:pathology; D008113:Liver Neoplasms / Q000175:diagnosis* / Q000473:pathology; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged
D003287:Contrast Media; C073590:gadolinium ethoxybenzyl DTPA; D019786:Gadolinium DTPA