Institutional members access full text with Ovid®

Share this article on:

Scirrhous Hepatocellular Carcinoma on Gadoxetic Acid–Enhanced Magnetic Resonance Imaging and Diffusion-Weighted Imaging: Emphasis on the Differentiation of Intrahepatic Cholangiocarcinoma

Park, Min Jung MD, PhD; Kim, Young Kon MD, PhD; Park, Hyun Jeong MD, PhD; Hwang, Jiyoung MD, PhD; Lee, Won Jae MD, PhD

Journal of Computer Assisted Tomography: November/December 2013 - Volume 37 - Issue 6 - p 872–881
doi: 10.1097/RCT.0b013e31829d44c1
Gastrointestinal Imaging

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).

Materials and 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.

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.

Received for publication April 16, 2013; accepted May 22, 2013.

Reprints: Young Kon Kim, MD, PhD, Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea (e-mail: jmyr@dreamwiz.com).

The authors state that they have no relevant financial interests or personal affiliations in connection with the content of this article.

Copyright © 2013 Wolters Kluwer Health, Inc. All rights reserved.