Keywords:
Abdomen, Liver, Oncology, CT, MR, Contrast agent-intravenous, Cirrhosis
Authors:
M. Gerboni, R. Faletti, S. Fiore, M. Gatti, F. Guarasci, L. J. Pavan, M. Donalisio, F. Gentile, P. Fonio; Turin/IT
DOI:
10.26044/ecr2019/C-3454
Methods and materials
Between November 2016 and December 2017 we recruited 51 consecutive patients with cirrhosis of the liver,
with a mean age of 63.23 years (41 males,
10 females),
with at least a “naïve” lesion showing atypical dynamics enhancement on multiphase CT scan (Revolution CT or Optima 660,
2ml/kg Iomeron® 400).
All these patients underwent Gd-EOB-DTPA MRI and were prospectively enrolled.
MR study performed with 1.5 T equipment (Achieva,
version 2.6,
Philips Medical Systems,
DA Best,
The Netherlands) with Sense XL Torso 16-element phased array Torso,
using hepatospecific contrast agent at a dose of 0.1 ml / kg (Primovist® 0,
25 mmol / ml) at a flow of 2 ml / sec with a study protocol: SS TSE T2; GRE T1 in phase and in phase opposition; GRE Fat Sat T1 by dynamic study before and during infusion of hepatospecific contrast agent (acquisition of 3 arterial phases in a single apnea); DWI (b values: 50,
600 and 1000); TSE T2 TSE Fat Sat T2; GRE Fat Sat T1 (three sequences with flip angle of 10° and 20 °) about 20 min from the infusion of hepato-specific contrast medium ev.
Images were reviewed by two radiologists in consensus.
The atypical lesions,
according to the "Diagnostic algorithm for hepatocellular carcinoma (HCC)" proposed by Renzulli et al,
were re-categorized by MRI into:
- group A) typical HCC
- group B) hypervascular without washout and hypointense in the hepatobiliary phase (HBP)
- group C) hypovascular nodules,
hypointense in the HBP,
hyperintense on DWI.
Patients were classified according to the Barcelona Clinic Liver Cancer (BCLC) guidelines prior and after MRI.
Data were analysed using non-parametric tests.