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Comparison of Portal Venous and Delayed Phases of Gadolinium-Enhanced Magnetic Resonance Imaging Study of Cirrhotic Liver for the Detection of Contrast Washout of Hypervascular Hepatocellular Carcinoma

Cereser, Lorenzo MD*; Furlan, Alessandro MD*; Bagatto, Daniele MD*; Girometti, Rossano MD*; Como, Giuseppe MD*; Avellini, Claudio MD; Orsaria, Maria MD; Zuiani, Chiara MD*; Bazzocchi, Massimo MD*

Journal of Computer Assisted Tomography: September-October 2010 - Volume 34 - Issue 5 - p 706-711
doi: 10.1097/RCT.0b013e3181e1a88e
Abdominal Imaging

Objective: To retrospectively compare portal venous phase (PVP) and delayed phase (DP) for the detection of tumor washout at gadobenate dimeglumine-enhanced liver magnetic resonance imaging (MRI) in cirrhotic patients with hypervascular hepatocellular carcinoma (HCC).

Methods: Thirty-three patients with 55 HCCs underwent 1.5-T MRI by means of fat-suppressed T1-weighted sequence obtained before and after gadobenate dimeglumine administration, during early and late arterial phases, PVP (70 seconds), and DP (180 seconds). Detection rates of contrast washout of hypervascular HCCs and tumor-to-liver contrast on PVP and DP were measured and compared.

Results: Among 54 hypervascular HCCs, washout was present in 24 (44%) of 54 tumors on PVP and in 44 (82%) of 54 on DP (P < 0.001). In 20 (37%) of 54 tumors, washout was deemed present only on DP. Delayed phase images yielded significantly higher mean tumor-to-liver contrast absolute values compared with PVP images (−24.5 [56.1] vs −9.3 [52.6], P = 0.001).

Conclusions: Delayed phase is superior to PVP for the washout detection of hypervascular HCC at gadobenate dimeglumine-enhanced MRI of cirrhotic liver.

From the *Institute of Diagnostic Radiology, and †Department of Pathology, University of Udine, Udine, Italy.

Received for publication January 14, 2010; accepted April 2, 2010.

Reprints: Lorenzo Cereser, MD, Institute of Diagnostic Radiology, University of Udine, Piazzale SM della Misericordia 15, 33100 Udine, Italy (e-mail:

The authors have no conflicts of interest, and there are no funding sources for the study.

Presented as scientific poster at the 20th Annual Meeting and Postgraduate Course of the European Society of Gastrointestinal and Abdominal Radiology, Valencia, Spain, June 23-26, 2009 (P-172) and at the 95th Scientific Assembly and Annual Meeting of the Radiological Society of North America, Chicago, Ill, November 29-December 4 (LL-GI2255-L05).

Dr Furlan is now with the Department of Radiology, University of Pittsburgh Medical Center, Pittsburgh, PA.

© 2010 Lippincott Williams & Wilkins, Inc.