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Paradoxical high signal intensity of hepatocellular carcinoma in the hepatobiliary phase of Gd-EOB-DTPA enhanced MRI: initial experience

Authors
Lee, Seun AhLee, Chang HeeJung, Woon YongLee, JongmeeChoi, Jae WoongKim, Kyeong AhPark, Cheol Min
Issue Date
1월-2011
Publisher
ELSEVIER SCIENCE INC
Keywords
Gadoxetic acid; Gd-EOB-DTPA; Green hepatoma; Hepatocellular carcinoma; Liver; MRI
Citation
MAGNETIC RESONANCE IMAGING, v.29, no.1, pp.83 - 90
Indexed
SCIE
SCOPUS
Journal Title
MAGNETIC RESONANCE IMAGING
Volume
29
Number
1
Start Page
83
End Page
90
URI
https://scholar.korea.ac.kr/handle/2021.sw.korea/113438
DOI
10.1016/j.mri.2010.07.019
ISSN
0730-725X
Abstract
Purpose: To describe the paradoxical high signal intensity of hepatocellular carcinoma (HCC) in the hepatobiliary phase on gadolinium-ethoxybenzyl-diethylenetriamine pentaacetic acid (Gd-EOB-DTPA)-enhanced magnetic resonance imaging (MRI). Materials and Methods: A database search was performed to identify cases of HCC that showed unusual prolonged enhancement in the hepatobiliary phase of Gd-EOB-DTPA MRI. All patients received 3.0-T liver MRI including precontrast T1-weighted images, T2-weighted images and a post Gd-EOB-DTPA-enhanced dynamic study. The signal intensity of HCC was measured at pre-enhanced, arterial, portal, delayed and hepatobiliary phase using regions of interest. Radiologic and pathologic correlation was performed for the paradoxically prolonged enhancing portion of HCC in the hepatobiliary phase. Results: Four patients (all male, age range 44-70; mean 57.5 years) were included in this study. All patients showed HCC lesions that were low signal intensity (SI) on T1-WI, high SI on T2-WI, enhanced in arterial phase, and washed-out in delayed phase. All cases showed paradoxically high SI in hepatobiliary phase, which was unusual for HCC. Pathologically, they were all diagnosed as well-differentiated HCC with prominent cytoplasm and a bile secreting appearance. Conclusion: HCC may demonstrate the prolonged high signal intensity at the hepatobiliary phase on Gd-EOB-DTPA enhanced MRI. These HCCs tended to be highly differentiated and to have prominent bile secretion. Crown Copyright (C) 2011 Published by Elsevier Inc. All rights reserved.
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