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Differentiation between hepatoma and hemangioma with inversion-recovery snapshot FLASH MRI and Gd-DTPA
T Murakami1, T Mitani, H Nakamura
1Department of Radiology, Osaka University Medical School, Japan.
Abstract:
Thirty-eight patients with focal liver tumors (20 hepatomas, 18 hemangiomas) were studied by dynamic sequential inversion recovery (IR) snapshot fast low angle shot (FLASH) MR imaging with Gd-DTPA. Immediately after 0.05 mmol/kg Gd-DTPA was administered intravenously for 2-3 s followed by flushing with normal saline for 4-5 s, 10 images were obtained in the first 20 s (time zero is the end of flush, early phase). Then, one image every 30 s from 1 to 3 min (late phase) and images at 5 min and 7 min (delayed phase) were obtained serially. Hepatomas showed total enhancement in 18 of 20 patients in the early phase, and isointense or low intensity enhancement with respect to the surrounding liver parenchyma in 18 patients in the late to delayed phases. Hemangiomas showed peripheral enhancement in 14 patients in the early phase, but did not show total enhancement (except for two hemangiomas less than 3 cm in size) in the early phase, and showed high intensity enhancement in 15 patients in the late phase. Ninety percent of hepatomas and 82% of hemangiomas showed their characteristic enhancement patterns in the early to delayed phases. We conclude that dynamic sequential IR snapshot FLASH MR images enhanced with Gd-DTPA can facilitate differentiation between hepatomas and hemangiomas.
Insights
Dynamic contrast-enhanced MRI using Gd-DTPA aids in differentiating focal liver tumors. Hepatomas show early total enhancement, while hemangiomas exhibit peripheral enhancement, enabling accurate diagnosis.
Area of Science:
- Radiology
- Medical Imaging
- Hepatology
Background:
- Focal liver tumors, including hepatomas and hemangiomas, require accurate differentiation for effective treatment.
- Distinguishing between these tumor types can be challenging with conventional imaging techniques.
Purpose of the Study:
- To evaluate the efficacy of dynamic sequential inversion recovery (IR) snapshot fast low angle shot (FLASH) Magnetic Resonance (MR) imaging with Gadolinium-Diethylenetriaminepentaacetic acid (Gd-DTPA) in differentiating hepatomas from hemangiomas.
Main Methods:
- Thirty-eight patients with focal liver tumors (20 hepatomas, 18 hemangiomas) underwent dynamic sequential IR snapshot FLASH MR imaging.
- Intravenous administration of Gd-DTPA followed by serial image acquisition in early, late, and delayed phases.
Main Results:
- Hepatomas demonstrated early phase total enhancement (18/20) and late/delayed isointense or low enhancement (18/20).
- Hemangiomas showed early peripheral enhancement (14/18) and late phase high intensity enhancement (15/18).
- Characteristic enhancement patterns were observed in 90% of hepatomas and 82% of hemangiomas.
Conclusions:
- Dynamic sequential IR snapshot FLASH MR imaging with Gd-DTPA is effective in differentiating between hepatomas and hemangiomas.
- The distinct enhancement patterns observed in different phases facilitate accurate diagnosis of focal liver tumors.