Changes in the signal- and contrast-to-noise ratios of hepatocellular carcinomas on gadoxetic acid-enhanced dynamic MR imaging |
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Authors: | Hyun Su Kim Dongil Choi Seong Hyun Kim Min Woo Lee Won Jae Lee Young Kon Kim Kyung Mi Jang Min Jung Park Cheol Keun Park |
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Affiliation: | 1. Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50, Ilwon-Dong, Kangnam-Ku, Seoul 135-710, Republic of Korea;2. Department of Pathology, Samsung Medical Center, Sungkyunkwan University School of Medicine, 50, Ilwon-Dong, Kangnam-Ku, Seoul 135-710, Republic of Korea |
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Abstract: | ObjectiveOur objective was to evaluate whether the enhancement pattern, measured by changes in the signal- (SNRs) and contrast-to-noise ratios (CNRs), of hepatocellular carcinomas (HCCs) on gadoxetic acid-enhanced MRI reflects tumor differentiation.Subjects and methodsTwo hundred eighty-five patients with 286 surgically-confirmed HCCs who underwent gadoxetic acid-enhanced MRI were included (11 grade I, 267 grade II, 7 grade III, and 1 grade IV tumor). Unenhanced and dynamic images with a T1-weighted 3D turbo-field-echo sequence were obtained. Relative signal intensities of the tumors with respect to surrounding liver were evaluated and the SNRs and CNRs were calculated.ResultsSNR measurements demonstrated a fluctuating pattern (an increase in the SNR, followed by a decrease and a subsequent increase [or a decrease in the SNR followed by an increase and a subsequent decrease]) in 282 of 286 (98.6%) tumors. The SNR measurements also showed a single-peak SNR in the arterial phase (1.0% [3/286]) and 3 min delayed images (0.3% [1/286]) followed by a decrease in 4 (1.4% [4/286]) grade II tumors. Nearly all tumors (88.1% [252/286]), 9 (81.8% [9/11]) grade I, 236 (88.4% [236/267]) grade II, 6 (85.7% [6/7]) grade III, and 1 (100% [1/1]) grade IV tumor showed maximum absolute CNRs with negative values, which were most commonly found in 20 min delayed images (67.5% [170/252]). The remaining 34 of 286 (11.9%) tumors showed maximum absolute CNRs with positive values.ConclusionRegardless of the tumor grades, the most common manifestation was a SNR with a fluctuating pattern with time and maximum absolute CNRs with negative values, which were most commonly noted in the hepatobiliary phase. |
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Keywords: | Enhanced MRI Gadoxetic acid Hepatocellular carcinoma SNR CNR |
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