Small hepatocellular carcinoma: Differentiation from adenomatous hyperplasia with color Doppler US and dynamic Gd-DTPA-enhanced MR imaging

Riccardo Lencioni, M. Mascalchi, D. Caramella, C. Bartolozzi

Research output: Contribution to journalArticle

52 Citations (Scopus)

Abstract

Background: To investigate the usefulness of color Doppler ultrasound (US) and dynamic Gd-DTPA-enhanced magnetic resonance (MR) imaging in the differentiation of small hepatocellular carcinoma (HCC) and adenomatous hyperplasia (AH). Methods: Thirty-eight small (3 cm or less) nodular lesions (in 38 cirrhotic patients) with US features consistent with HCC underwent evaluation with color Doppler US and MR imaging. Breath-hold T1-weighted rapid acquisition spin echo MR sequence after bolus injection of 0.1 mmol/kg gadopentetate dimeglumine was used to evaluate dynamic enhancement. US-guided tissue-core percutaneous biopsy established the diagnosis: HCC in 28 cases and AH in 10. Results: Color signals with pulsatile or continuous Doppler spectrum were demonstrated in 19 of 28 HCCs (68%) but in none of the AHs. Although there was considerable overlap in signal intensity between HCC and AH on both unenhanced T1- and T2-weighted images, early enhancement on breath-hold T1-weighted images obtained 40 s after starting contrast administration was observed in 22 of 28 HCCs (79%) but in none of the AHs. In 26 of 28 HCCs (93%), pulsatile or continuous flow at color Doppler US, early enhancement at dynamic MR imaging, or both were observed. Conclusion: Findings with color Doppler US and dynamic Gd-DTPA-enhanced MR imaging enable a reliable distinction between small HCC and AH.

Original languageEnglish (US)
Pages (from-to)41-48
Number of pages8
JournalAbdominal Imaging
Volume21
Issue number1
StatePublished - Jan 1996
Externally publishedYes

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Doppler Ultrasonography
Gadolinium DTPA
Hyperplasia
Hepatocellular Carcinoma
Color
Magnetic Resonance Imaging
Image Enhancement
Magnetic Resonance Spectroscopy
Biopsy
Injections

Keywords

  • Liver neoplams, MR
  • Liver neoplams, US
  • Liver neoplasms
  • Liver neoplasms, diagnosis
  • Liver, cirrhosis
  • US, Doppler study

ASJC Scopus subject areas

  • Gastroenterology
  • Radiology Nuclear Medicine and imaging
  • Urology
  • Radiological and Ultrasound Technology

Cite this

Small hepatocellular carcinoma : Differentiation from adenomatous hyperplasia with color Doppler US and dynamic Gd-DTPA-enhanced MR imaging. / Lencioni, Riccardo; Mascalchi, M.; Caramella, D.; Bartolozzi, C.

In: Abdominal Imaging, Vol. 21, No. 1, 01.1996, p. 41-48.

Research output: Contribution to journalArticle

Lencioni, Riccardo ; Mascalchi, M. ; Caramella, D. ; Bartolozzi, C. / Small hepatocellular carcinoma : Differentiation from adenomatous hyperplasia with color Doppler US and dynamic Gd-DTPA-enhanced MR imaging. In: Abdominal Imaging. 1996 ; Vol. 21, No. 1. pp. 41-48.
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abstract = "Background: To investigate the usefulness of color Doppler ultrasound (US) and dynamic Gd-DTPA-enhanced magnetic resonance (MR) imaging in the differentiation of small hepatocellular carcinoma (HCC) and adenomatous hyperplasia (AH). Methods: Thirty-eight small (3 cm or less) nodular lesions (in 38 cirrhotic patients) with US features consistent with HCC underwent evaluation with color Doppler US and MR imaging. Breath-hold T1-weighted rapid acquisition spin echo MR sequence after bolus injection of 0.1 mmol/kg gadopentetate dimeglumine was used to evaluate dynamic enhancement. US-guided tissue-core percutaneous biopsy established the diagnosis: HCC in 28 cases and AH in 10. Results: Color signals with pulsatile or continuous Doppler spectrum were demonstrated in 19 of 28 HCCs (68{\%}) but in none of the AHs. Although there was considerable overlap in signal intensity between HCC and AH on both unenhanced T1- and T2-weighted images, early enhancement on breath-hold T1-weighted images obtained 40 s after starting contrast administration was observed in 22 of 28 HCCs (79{\%}) but in none of the AHs. In 26 of 28 HCCs (93{\%}), pulsatile or continuous flow at color Doppler US, early enhancement at dynamic MR imaging, or both were observed. Conclusion: Findings with color Doppler US and dynamic Gd-DTPA-enhanced MR imaging enable a reliable distinction between small HCC and AH.",
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