Appearance of hepatocellular adenomas on gadoxetic acid-enhanced MRI.

Abstract

OBJECTIVE:

The purpose of this study was to evaluate enhancement characteristics of hepatocellular adenomas (HCAs) using gadoxetic acid as a hepatocyte-specific MR contrast agent.

METHODS:

Twenty-four patients with histopathologically proven HCAs were retrospectively identified. MRI consisted of T1- and T2-weighted (w) sequences with and without fat saturation (fs), multiphase dynamic T1-w images, and fs T1-w images during the hepatobiliary phase. Standard of reference was surgical resection (n = 19) or biopsy (n = 5). Images were analysed for morphology and contrast behaviour including signal intensity (SI) measurement on T1-w images normalised to the pre-contrast base line.

RESULTS:

In total 34 HCAs were evaluated. All HCAs showed enhancement in the arterial phase; 38 % of HCAs showed reduced contrast enhancement ("wash-out") in the venous phase. All HCAs showed enhancement (SI increase, 56 ± 53 %; P <0.001) in the hepatobiliary phase, although liver uptake was stronger (96 ± 58 %). Thus, 31 of all HCAs (91 %) appeared hypointense to the surrounding liver in the hepatobiliary phase, while 3 out of 34 lesions were iso-/hyperintense.

CONCLUSIONS:

Gadoxetic acid accumulates in HCAs in the hepatobiliary phase, although significantly less than in surrounding liver. Thus, HCA appears in the vast majority of cases as a hypointense lesion on hepatobiliary phase images.

KEY POINTS:

• Magnetic resonance-specific contrast agents are now available for hepatic imaging. • Hepatocellular adenomas enhance with gadoxetic acid as in previous CT/MRI experience. • Enhancement during the hepatobiliary phase is less in HCAs than in liver. • Typical HCAs appear as hypointense lesions on T1-w hepatobiliary phase images. • True hyperintense HCA enhancement can occasionally occur during the hepatobiliary phase.

• Authors: Timm Denecke, Ingo G Steffen, Sheela Agarwal, Daniel Seehofer, Thomas Kröncke, Enrique Lopez Hänninen, Incken-Birthe Kramme, Peter Neuhaus, Sanjay Saini, Bernd Hamm, Christian Grieser
• Journal: European radiology (Eur Radiol) Vol. 22 Issue 8 Pg. 1769-75 (Aug 2012) ISSN: 1432-1084 [Electronic] Germany
• PMID: 22437921 (Publication Type: Journal Article)

Chemical References

• Contrast Media
• gadolinium ethoxybenzyl DTPA
• Gadolinium DTPA

Topics

• Adenoma, Liver Cell (diagnosis, pathology)
• Adult
• Aged
• Arteries (pathology)
• Biopsy (methods)
• Contrast Media (pharmacology)
• Diagnostic Imaging (methods)
• Female
• Gadolinium DTPA (pharmacology)
• Humans
• Image Processing, Computer-Assisted (methods)
• Liver Neoplasms (diagnosis, pathology)
• Magnetic Resonance Imaging (methods)
• Middle Aged
• Retrospective Studies
• Tomography, X-Ray Computed (methods)