Gadoxetic Acid-Enhanced Magnetic Resonance Imaging for Differentiating Small Hepatocellular Carcinomas (≤2 cm in Diameter) From Arterial Enhancing Pseudolesions

作者：Hye Young Sun, Jeong Min Lee, Cheong II Shin, Dong Ho Lee, Sung Kyoung Moon, Kyung Won Kim, Joon Koo Han, Byung Ihn Choi · 发表于：Investigative Radiology · 年份：2010 · DOI：10.1097/rli.0b013e3181c5faf7 · 被引用次数：214 · 研究领域：Hepatocellular Carcinoma Treatment and Prognosis、Liver Disease Diagnosis and Treatment、Organ Transplantation Techniques and Outcomes

OBJECTIVES: To determine the characteristic enhancing features of hepatocellular carcinoma (HCC) and arterial-enhancing pseudolesion (AEP) on gadoxetic acid (Primovist)-enhanced magnetic resonance imaging (MRI) and to assess its performance compared with that of multirow detector computed tomography (MDCT) for differentiating small HCC (< or =2 cm in diameter) from AEP in cirrhotic liver. MATERIALS AND METHODS: A total of 69 patients with 97 small, arterial enhancing hepatic lesions (0.5-2 cm in diameter), ie, 44 HCCs and 53 AEPs, detected on gadoxetic acid-enhanced MRI, were included in this study. HCCs were diagnosed either through histopathology confirmation (n = 16) or by a combination of liver computed tomography (CT), angiographic findings, lipiodol CT, and AFP levels (n = 28). AEPs were diagnosed either through histopathology confirmation (n = 2) or were based on the angiographic findings, liver CT, and follow-up imaging (n = 51). Two radiologists jointly analyzed the morphologic features and the enhancement characteristics on the gadoxetic acid-enhanced MRI. Of the 69 study patients, 42 patients with 60 arterial enhancing lesions underwent quadruple-phase CT in addition to their MRI examination within 4 weeks before or after the MRI, and 2 other radiologists who were blinded to the final diagnosis independently reviewed the MRI and CT images in random order, at an interval of 2 weeks. Diagnostic performance was evaluated using receiver operating characteristics. The K...