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Small hypervascular hepatocellular carcinoma versus hypervascular pseudolesions: differential diagnosis on MRI
1Department of Radiology, Niigata University Faculty of Medicine, 1-757, Asahimachi-Dori, Niigata, 951-8510, Japan.
Background:
We wanted to differentiate small hypervascular hepatocellular carcinoma (HCC) from hypervascular pseudolesion (HPL) on magnetic resonance imaging (MRI).
Methods:
We reviewed small hypervascular foci (< or = 2 cm in diameter) on dynamic MRI in patients with chronic liver disease, which were followed-up with serial MRI examinations.
Results:
Twenty of 34 hypervascular foci were larger at follow-up; 19 of 20 foci had characteristics suggesting HCC; and 14 foci did not grow or disappeared and were judged to be HPLs. There were no differences in the initial sizes and follow-up periods between HCCs and HPLs. On initial MRI, nine of 19 HCCs (47%) and one of 14 HPLs (7%) appeared hyperintense on T2-weighted images. The difference between HCCs and HPLs on T2-weighted images was statistically significant (p = 0.039).
Conclusion:
HPLs are seen frequently as small hypervascular foci on dynamic MRI in patients with chronic liver disease. Hyperintensity of the foci on T2-weighted images differentiates HCCs from HPLs.