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Hepatocellular carcinoma: evaluation with dynamic and static gadobenate dimeglumine-enhanced MR imaging and
T J Vogl1, A Stupavsky, W Pegios
1Department of Radiology, Rudolf Virchow Clinic, Humboldt-University of Berlin, Rudolf Virchow Hospital, Germany.
Purpose:
To analyze the potential of gadobenate dimeglumine-enhanced magnetic resonance (MR) imaging for the characterization and diagnosis of hepatocellular carcinoma (HCC) by using static and dynamic sequences.
Materials And Methods:
Twenty-eight patients with histopathologically proved HCC were evaluated with T1- and T2-weighted spin-echo and static and dynamic gradient-echo sequences before, during, and after intravenous administration of 0.1 mmol/kg gadobenate dimeglumine (0.5 mol/L).
Results:
During the perfusion phase of the dynamic sequence, all 16 nodular well-differentiated HCC lesions showed a rapid increase in signal intensity 10-30 seconds after injection followed by a progressive decrease in signal intensity. The nine poorly differentiated HCC lesions showed no rapid increase in signal intensity. All eight large (> 3 cm), nodular, well-differentiated HCC lesions showed a hypointense rim before injection and both hypo- and hyperintense rims (double-ring sign) immediately after injection, compared with normal liver parenchyma. About 55 seconds after injection, substantial single-rim enhancement was detected in 21 of the 28 HCC lesions.
Conclusion:
Dynamic gadobenate dimeglumine-enhanced MR imaging allows improved characterization of HCC lesions, which show rapid increase in signal intensity during the early, arterial phase in well-differentiated HCC lesions and a double-ring sign in large well-differentiated nodular HCC lesions.