title: Enhancement pattern analysis of hypervascular hepatocellular carcinoma on dynamic MR imaging with histopathological correlation: validity of portal phase imaging for predicting tumor grade.
abstract: OBJECTIVE
  To elucidate the correlation between hypervascular hepatocellular carcinoma (HCC) enhancement patterns on dynamic MR imaging and histological findings.
  
  
  METHODS
  Surgically proven 46 hypervascular HCCs of forty-one patients were enrolled. For each HCC, the signal intensity in the portal phase (SIPP) was evaluated. In this study, high, iso-, or low intensity in the portal phase was hypothesized as late, moderate, or early washout pattern, respectively. The SIPP of each HCC was correlated to histological grade and architectural subtypes that represent degrees of trabecular structure. For the trabecular HCCs, the thickness of tumor plate was also correlated for indirect estimation of tumor sinusoid.
  
  
  RESULTS
  There was a significant correlation between the SIPP vs. histological grade and also vs. architectural subtypes, namely the degree of trabecular structure. Washout of hypervascular HCC occurred earlier as the histological grade advanced and the histological architecture got closer to pure trabecular HCC. For the trabecular HCCs, the thickness of tumor plate correlated significantly with SIPP or histological grade. Hypervascular HCCs with thicker tumor plates showed worse histological grade and earlier washout pattern.
  
  
  CONCLUSIONS
  Histological grade of hypervascular HCC may be predicted using SIPP. The thickness of tumor plate, resultantly the size of sinusoid between tumor plates, can account for the relationship between washout pattern and histological grade in the trabecular HCCs.
authors.affiliation: Departments of Clinical Radiology, Graduate School of Medical Sciences, Kyushu University, Japan.
authors.forename: Daisuke
authors.initials: D
authors.lastname: Okamoto
authors.forename: Kengo
authors.initials: K
authors.lastname: Yoshimitsu
authors.forename: Akihiro
authors.initials: A
authors.lastname: Nishie
authors.forename: Tsuyoshi
authors.initials: T
authors.lastname: Tajima
authors.forename: Yoshiki
authors.initials: Y
authors.lastname: Asayama
authors.forename: Kousei
authors.initials: K
authors.lastname: Ishigami
authors.forename: Masakazu
authors.initials: M
authors.lastname: Hirakawa
authors.forename: Yasuhiro
authors.initials: Y
authors.lastname: Ushijima
authors.forename: Daisuke
authors.initials: D
authors.lastname: Kakihara
authors.forename: Tomohiro
authors.initials: T
authors.lastname: Nakayama
authors.forename: Yunosuke
authors.initials: Y
authors.lastname: Nishihara
authors.forename: Shinichi
authors.initials: S
authors.lastname: Aishima
authors.forename: Akinobu
authors.initials: A
authors.lastname: Taketomi
authors.forename: Junji
authors.initials: J
authors.lastname: Kishimoto
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Honda
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D006528:Carcinoma, Hepatocellular / Q000473:pathology*; D005260:Female; D019786:Gadolinium DTPA; D006801:Humans; D008113:Liver Neoplasms / Q000473:pathology*; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D060787:Neoplasm Grading; D009389:Neovascularization, Pathologic / Q000473:pathology*; D012189:Retrospective Studies; D018709:Statistics, Nonparametric
chemical_list: D019786:Gadolinium DTPA