title: Scirrhous hepatocellular carcinoma on gadoxetic acid-enhanced magnetic resonance imaging and diffusion-weighted imaging: emphasis on the differentiation of intrahepatic cholangiocarcinoma.
abstract: OBJECTIVE
  The objective of this study was to determine the features of scirrhous hepatocellular carcinoma (sHCC) on gadoxetic acid-enhanced magnetic resonance imaging (MRI) and diffusion-weighted imaging (DWI) with an emphasis on the differentiation from intrahepatic cholangiocarcinoma (ICC).
  
  
  METHODS
  A total of 41 patients with sHCCs and 41 patients with ICCs underwent gadoxetic acid-enhanced MRI and DWI. Images were analyzed for shape of lesions, surface retraction, enhancement pattern, proportion of arterial hyperenhancement, target appearance on the hepatobiliary phase and DWI, and presence of necrosis.
  
  
  RESULTS
  Lobulating shape, rim enhancement, and target appearance on the hepatobiliary phase and DWI were the main features in both tumors. The proportion of arterial hyperenhancement of 20% of tumor diameter or more was the only significant MRI feature for differentiating sHCC from ICC (P ≤ 0.006 in the multivariate analysis).
  
  
  CONCLUSIONS
  Although the features of sHCC on gadoxetic acid-enhanced MRI and DWI are similar to those of ICC, the proportion of hyperenhancement of 20% or more on the arterial phase is a helpful feature in distinguishing sHCC from ICC.
authors.affiliation: From the *Department of Radiology and Research Institute of Radiological Science, Severance Hospital, Yonsei University College of Medicine; † Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine; and ‡Department of Radiology, Soonchunhyang University Seoul Hospital, Soonchunhyang University School of Medicine, Seoul, Republic of Korea.
authors.forename: Min Jung
authors.initials: MJ
authors.lastname: Park
authors.forename: Young Kon
authors.initials: YK
authors.lastname: Kim
authors.forename: Hyun Jeong
authors.initials: HJ
authors.lastname: Park
authors.forename: Jiyoung
authors.initials: J
authors.lastname: Hwang
authors.forename: Won Jae
authors.initials: WJ
authors.lastname: Lee
mesh_terms: D002293:Adenocarcinoma, Scirrhous / Q000473:pathology*; D000328:Adult; D000368:Aged; D006528:Carcinoma, Hepatocellular / Q000473:pathology*; D018281:Cholangiocarcinoma / Q000473:pathology*; D003287:Contrast Media; D003937:Diagnosis, Differential; D038524:Diffusion Magnetic Resonance Imaging / Q000379:methods*; D005260:Female; D019786:Gadolinium DTPA; D006801:Humans; D008113:Liver Neoplasms / Q000473:pathology*; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity
chemical_list: D003287:Contrast Media; C073590:gadolinium ethoxybenzyl DTPA; D019786:Gadolinium DTPA