Characterization of the arterial enhancement pattern of focal liver lesions by multiple arterial phase magnetic resonance imaging: comparison between hepatocellular carcinoma and focal nodular hyperplasia

2020 ◽  
Vol 125 (4) ◽  
pp. 348-355
Author(s):  
Marco Gatti ◽  
Marco Calandri ◽  
Laura Bergamasco ◽  
Fatemeh Darvizeh ◽  
Luigi Grazioli ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Hepatocellular Carcinoma ◽  
Magnetic Resonance ◽  
Arterial Phase ◽  
Focal Liver Lesions ◽  
Liver Lesions ◽  
Resonance Imaging ◽  
Enhancement Pattern ◽  
Nodular Hyperplasia

Contrast-enhanced ultrasound features of hepatocellular carcinoma not detected during the screening procedure

2017 ◽  
Vol 55 (08) ◽  
pp. 748-753
Author(s):  
Yi Dong ◽  
Wen-Ping Wang ◽  
Feng Mao ◽  
Christoph Dietrich
Keyword(s):  
Magnetic Resonance Imaging ◽  
Hepatocellular Carcinoma ◽  
Magnetic Resonance ◽  
Screening Procedure ◽  
Arterial Phase ◽  
Contrast Enhanced Ultrasound ◽  
Resonance Imaging ◽  
Contrast Enhanced ◽  
Patients At Risk

Abstract Aim The aim of this retrospective study is to report on the characteristics of contrast-enhanced ultrasound (CEUS) of primarily not detected hepatocellular carcinoma (HCC) during the screening procedure of patients at risk. Methods Sixty-four patients with a finally solitary and histologically proven HCC not detected HCC during the screening procedure were retrospectively analyzed. Most of HCC lesions (90.6 %, 58/64) measured < 20 mm in diameter. All HCC lesions were not detected during the initial screening procedure but suspected using contrast-enhanced magnetic resonance imaging. The final gold standard was biopsy or surgery with histological examination. Results On CEUS, 62/64 (96.8 %) of HCC were characterized as an obviously hyperenhanced lesion in arterial phase, and 41/64 (64.1 %) of HCC were characterized as hypoenhancing lesions in the portal venous and late phases. During the arterial phase of CEUS, 96.8 % of HCC displayed homogeneous hyperenhancement. Knowing the CEUS and magnetic resonance imaging findings, 45/64 (70.3 %) could have been detected using B-mode ultrasound (BMUS). Conclusion BMUS as a screening procedure is generally accepted. Contrast-enhanced imaging modalities have improved detection and characterization of HCC. Homogeneous hyperenhancement during the arterial phase and mild washout are indicative for HCC in liver cirrhosis.

scholarly journals Improved Characterization of Focal Liver Lesions With Liver-Specific Gadoxetic Acid Disodium-Enhanced Magnetic Resonance Imaging

2010 ◽  
Vol 34 (2) ◽  
pp. 163-172 ◽  
Author(s):  
Steven S. Raman ◽  
Christopher Leary ◽  
David A. Bluemke ◽  
Marco Amendola ◽  
Dushyant Sahani ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Gadoxetic Acid ◽  
Focal Liver Lesions ◽  
Liver Lesions ◽  
Resonance Imaging ◽  
Gadoxetic Acid Disodium

Magnetic resonance imaging of focal liver lesions: Approach to imaging diagnosis

Hepatology ◽  
2011 ◽  
Vol 54 (6) ◽  
pp. 2227-2237 ◽  
Author(s):  
Kathryn J. Fowler ◽  
Jeffrey J. Brown ◽  
Vamsi R. Narra
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Focal Liver Lesions ◽  
Liver Lesions ◽  
Resonance Imaging ◽  
Imaging Diagnosis

scholarly journals Magnetic resonance imaging of the cirrhotic liver: diagnosis of hepatocellular carcinoma and evaluation of response to treatment - Part 1

2017 ◽  
Vol 50 (1) ◽  
pp. 38-47 ◽  
Author(s):  
Miguel Ramalho ◽  
António P. Matos ◽  
Mamdoh AlObaidy ◽  
Fernanda Velloni ◽  
Ersan Altun ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Hepatocellular Carcinoma ◽  
Liver Cirrhosis ◽  
Magnetic Resonance ◽  
Cirrhotic Liver ◽  
Response To Treatment ◽  
Arterial Phase ◽  
Resonance Imaging ◽  
Regenerative Nodules ◽  
Magnetic Resonance Imaging Mri

Abstract Magnetic resonance imaging (MRI) is the modern gold standard for the noninvasive evaluation of the cirrhotic liver. The combination of arterial phase hyperenhancement and delayed wash-out allows a definitive diagnosis of hepatocellular carcinoma (HCC) in patients with liver cirrhosis or chronic liver disease, without the requirement for confirmatory biopsy. That pattern is highly specific and has been endorsed in Western and Asian diagnostic guidelines. However, the sensitivity of the combination is relatively low for small HCCs. In this two-part review paper, we will address MRI of the cirrhotic liver. In this first part, we provide a brief background on liver cirrhosis and HCC, followed by descriptions of imaging surveillance of liver cirrhosis and the diagnostic performance of the different imaging modalities used in clinical settings. We then describe some of the requirements for the basic MRI technique, as well as the standard MRI protocol, and provide a detailed description of the appearance of various types of hepatocellular nodules encountered in the setting of the carcinogenic pathway in the cirrhotic liver, ranging from regenerative nodules to HCC.

scholarly journals An overview of hepatocellular carcinoma with atypical enhancement pattern: spectrum of magnetic resonance imaging findings with pathologic correlation

2021 ◽  
Vol 0 (0) ◽  
Author(s):  
Jelena Djokic Kovac ◽  
Aleksandar Ivanovic ◽  
Tamara Milovanovic ◽  
Marjan Micev ◽  
Francesco Alessandrino ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Hepatocellular Carcinoma ◽  
Magnetic Resonance ◽  
Cirrhotic Liver ◽  
Hepatobiliary Phase ◽  
Imaging Findings ◽  
Resonance Imaging ◽  
Enhancement Pattern ◽  
Diffusion Restriction ◽  
Mri Features

Abstract Background In the setting of cirrhotic liver, the diagnosis of hepatocellular carcinoma (HCC) is straightforward when typical imaging findings consisting of arterial hypervascularity followed by portal-venous washout are present in nodules larger than 1 cm. However, due to the complexity of hepatocarcinogenesis, not all HCCs present with typical vascular behaviour. Atypical forms such as hypervascular HCC without washout, isovascular or even hypovascular HCC can pose diagnostic dilemmas. In such cases, it is important to consider also the appearance of the nodules on diffusion-weighted imaging and hepatobiliary phase. In this regard, diffusion restriction and hypointensity on hepatobiliary phase are suggestive of malignancy. If both findings are present in hypervascular lesion without washout, or even in iso- or hypovascular lesion in cirrhotic liver, HCC should be considered. Moreover, other ancillary imaging findings such as the presence of the capsule, fat content, signal intensity on T2-weighted image favour the diagnosis of HCC. Another form of atypical HCCs are lesions which show hyperintensity on hepatobiliary phase. Therefore, the aim of the present study was to provide an overview of HCCs with atypical enhancement pattern, and focus on their magnetic resonance imaging (MRI) features. Conclusions In order to correctly characterize atypical HCC lesions in cirrhotic liver it is important to consider not only vascular behaviour of the nodule, but also ancillary MRI features, such as diffusion restriction, hepatobiliary phase hypointensity, and T2-weighted hyperintensity. Fat content, corona enhancement, mosaic architecture are other MRI feautures which favour the diagnosis of HCC even in the absence of typical vascular profile.

scholarly journals The possibility of applying magnetic resonance imaging with hepatospecific contrast agent.

2018 ◽  
Vol 96 (3) ◽  
pp. 213-221
Author(s):  
Karina K. Lomovtseva ◽  
G. G. Karmazanovsky
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Contrast Agent ◽  
Gadoxetic Acid ◽  
Focal Liver Lesions ◽  
Hepatobiliary Phase ◽  
Liver Lesions ◽  
Resonance Imaging ◽  
Cross Sectional ◽  
Extracellular Contrast Agent

Nowadays, it is difficult to overestimate the role of cross-sectional imaging in the diagnosis of focal and diffuse liver diseases. In magnetic resonance imaging (MRI) there is a unique opportunity to use hepatospecific contrast agents compared with other visualization techniques. Gadoxetic acid is a hepatospecific magnetic resonance contrast agent which has the extracellular contrast agent properties and hepatotropic property. About half of the administered dose of gadoxetic acid enters into functioning hepatocytes through cell membrane transporters and then is excreted into the bile ducts and sinusoidal space. The obtained hepatobiliary phase provides information about the structural features of the focal liver lesions, improving their detection and differential diagnosis. In addition it allows to assess the anatomical and functional conditions of the hepatobiliary system. This article describes clinical applications of MRI with gadoxetic acid and its benefits, visualization principles of different focal liver lesions in hepatobiliary phase and features of the obtained images.

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