title: Infiltrative hepatocellular carcinoma on gadoxetic acid-enhanced and diffusion-weighted MRI at 3.0T.
abstract: OBJECTIVE
  To determine imaging features of infiltrative hepatocellular carcinoma (HCC) on 3T magnetic resonance imaging (MRI) including gadoxetic acid-enhanced and diffusion-weighted imaging (DWI).
  
  
  METHODS
  Eighteen patients with infiltrative HCC underwent liver MRI that consisted of T1- and T2-weighted image (T2WI), gadoxetic acid-enhanced arterial, portal, 3-min late and 20-min hepatobiliary phase (HBP), and DWI. Two reviewers evaluated in consensus tumor characteristics and lesion conspicuity using a 4-point scale. The tumor-to-liver contrast ratio was also measured.
  
  
  RESULTS
  Most of the tumors (n = 16, 88.9%) were seen as irregular permeative masses (4.0-23.0 cm, mean 10.5 cm in diameter) and the remaining two as poorly defined amorphous infiltration among thrombosed portal veins. Internal reticulation within the tumor was characteristic and was most frequently observed on 3-min late phase (n = 18), followed by HBP (n = 15). Tumor conspicuity and tumor-to-liver contrast ratio was highest with b-800 DWI, which was significantly higher than those of other images (P < 0.05).
  
  
  CONCLUSIONS
  DWI provides the highest conspicuity for infiltrative HCC compared to unenhanced T1- and T2WI and gadoxetic acid-enhanced MRI. The gadoxetic acid-enhanced 3-min late image is useful in characterizing infiltrative HCC, as it clearly depicts internal reticulation in all tumors.
authors.affiliation: Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
authors.forename: SangHyeok
authors.initials: S
authors.lastname: Lim
authors.forename: Young Kon
authors.initials: YK
authors.lastname: Kim
authors.forename: Hyun Jeong
authors.initials: HJ
authors.lastname: Park
authors.forename: Won Jae
authors.initials: WJ
authors.lastname: Lee
authors.forename: Dongil
authors.initials: D
authors.lastname: Choi
authors.forename: Min Jung
authors.initials: MJ
authors.lastname: Park
mesh_terms: D000328:Adult; D000368:Aged; D006528:Carcinoma, Hepatocellular / Q000473:pathology*; D003287:Contrast Media; D038524:Diffusion Magnetic Resonance Imaging / Q000379:methods*; D005260:Female; D019786:Gadolinium DTPA; D006801:Humans; D007089:Image Enhancement / Q000379:methods; D008113:Liver Neoplasms / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D015588:Observer Variation; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity
chemical_list: D003287:Contrast Media; C073590:gadolinium ethoxybenzyl DTPA; D019786:Gadolinium DTPA
keywords: Gd-EOB-DTPA; diffusion weighted imaging; infiltrative hepatocellular carcinoma; liver; magnetic resonance imaging