Skip Navigation LinksHome > March/April 2011 - Volume 35 - Issue 2 > Gadolinium Ethoxybenzyl Diethylenetriamine Pentaacetic Acid-...
Journal of Computer Assisted Tomography:
doi: 10.1097/RCT.0b013e3182026f3b
Abdominal Imaging

Gadolinium Ethoxybenzyl Diethylenetriamine Pentaacetic Acid-Enhanced Magnetic Resonance Imaging Findings of Borderline Lesions at High Risk for Progression to Hypervascular Classic Hepatocellular Carcinoma

Kobayashi, Satoshi MD; Matsui, Osamu MD; Gabata, Toshifumi MD; Koda, Wataru MD; Minami, Tetsuya MD; Ryu, Yasuji MD; Kawai, Keiichi MD; Kozaka, Kazuto MD

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Objectives: The objectives of the study were to assess the imaging features of hypovascular borderline lesions containing hypervascular foci on gadolinium ethoxybenzyl diethylenetriamine pentaacetic acid (Gd-EOB-DTPA)-enhanced magnetic resonance imaging (MRI) and to evaluate the ability of Gd-EOB-DTPA-enhanced MRI to diagnose high-risk borderline lesions possibly consistent with early hepatocellular carcinoma (HCC).

Methods: Institutional review board approval was obtained for this retrospective analysis of imaging findings, and informed consent was obtained from 217 consecutive patients undergoing Gd-EOB-DTPA-enhanced MRI and angiography-assisted computed tomography (CT) for examination of hepatocellular nodular lesions in cirrhotic livers. There were 73 nodules showing hypervascular foci in borderline lesions identified by angiography-assisted CT. Signal intensity patterns of the nodules were evaluated on hepatobiliary-phase Gd-EOB-DTPA-enhanced T1-weighted MRI obtained 20 minutes after intravenous injection of contrast media.

Results: Among 73 high-risk borderline lesions, 59 were hypointense (81%), and 14 were isointense (19%), compared with background liver parenchyma. There were 27 untreated lesions followed by CT and/or MRI. Almost half of these nodules transformed into hypervascular HCC, regardless of signal intensities seen on hepatobiliary-phase Gd-EOB-DTPA-enhanced MRI.

Conclusions: Although many high-risk borderline HCC lesions are hypointense on hepatobiliary-phase Gd-EOB-DTPA-enhanced MRI, some high-risk borderline lesions are isointense and transform at the same rate into hypervascular HCC.

© 2011 Lippincott Williams & Wilkins, Inc.



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