Small hepatocellular carcinoma: differentiation from adenomatous hyperplasia with color Doppler US and dynamic Gd-DTPA-enhanced MR imaging |
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Authors: | R Lencioni M Mascalchi D Caramella C Bartolozzi |
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Institution: | (1) Department of Radiology, University of Pisa, Via Roma 67, I-56100 Pisa, Italy, IT |
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Abstract: | Background: To investigate the usefulness of color Doppler ultrasound (US) and dynamic Gd-DTPA-enhanced magnetic resonance (MR) imaging
in the differentiation of small hepatocellular carcinoma (HCC) and adenomatous hyperplasia (AH).
Methods: Thirty-eight small (3 cm or less) nodular lesions (in 38 cirrhotic patients) with US features consistent with HCC underwent
evaluation with color Doppler US and MR imaging. Breath-hold T1-weighted rapid acquisition spin echo MR sequence after bolus
injection of 0.1 mmol/kg gadopentetate dimeglumine was used to evaluate dynamic enhancement. US-guided tissue-core percutaneous
biopsy established the diagnosis: HCC in 28 cases and AH in 10.
Results: Color signals with pulsatile or continuous Doppler spectrum were demonstrated in 19 of 28 HCCs (68%) but in none of the AHs.
Although there was considerable overlap in signal intensity between HCC and AH on both unenhanced T1- and T2-weighted images,
early enhancement on breath-hold T1-weighted images obtained 40 s after starting contrast administration was observed in 22
of 28 HCCs (79%) but in none of the AHs. In 26 of 28 HCCs (93%), pulsatile or continuous flow at color Doppler US, early enhancement
at dynamic MR imaging, or both were observed.
Conclusion: Findings with color Doppler US and dynamic Gd-DTPA-enhanced MR imaging enable a reliable distinction between small HCC and
AH.
Received: 8 August 1994/Accepted after revision: 27 January 1995 |
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Keywords: | : Liver cirrhosis— Liver neoplasms— Liver neoplasms diagnosis— Liver neoplams MR— Liver neoplams US— US Doppler study |
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