Intranodular signal intensity analysis of hypovascular high-risk borderline lesions of HCC that illustrate multi-step hepatocarcinogenesis within the nodule on Gd-EOB-DTPA-enhanced MRI

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• 作者：Satoshi Kobayashi ; ^{satoshik@staff.kanazawa-u.ac.jp} ; Osamu Matsui ^{matsuio@med.kanazawa-u.ac.jp} ; Toshifumi Gabata ^{gabata@med.kanazawa-u.ac.jp} ; Wataru Koda ^{wkoda@staff.kanazawa-u.ac.jp} ; Tetsuya Minami ^{tminami@staff.kanazawa-u.ac.jp} ; Yasuji Ryu ^{yryu-kanazawa@umin.ac.jp} ; Kazuto Kozaka ^{k-kozaka@staff.kanazawa-u.ac.jp} ; Azusa Kitao ^{azusa@med.kanazawa-u.ac.jp}
• 关键词：Hepatocellular carcinoma ; Borderline lesion ; Gd&ndash ; EOB&ndash ; DTPA
• 刊名：European Journal of Radiology
• 出版年：2012
• 出版时间：December, 2012
• 年：2012
• 卷：81
• 期：12
• 页码：3839-3845
• 全文大小：1078 K

文摘

Objectives

To analyze intranodular signal intensity pattern of hypovascular high-risk borderline lesions of HCC that illustrate multi-step hepatocarcinogenesis within the nodule on Gd-EOB-DTPA-enhanced MRI.

Methods

A total of 73 nodules showing hypervascular foci in hypovascular high-risk borderline lesions identified by angiography-assisted CT were included in this study. The intranodular signal intensities of both the hypervascular foci and the hypovascular high-risk borderline lesions were evaluated on hepatobiliary-phase EOB-enhanced MRI obtained 20 min after intravenous injection of contrast media.

Results

Among 59 hypervascular foci within hypointense hypovascular high-risk borderline lesions, 6 showed more hypointensity, 32 isointensity, and 21 hyperintensity compared to the surrounding hypointense, hypovascular portion of the nodules. Among 14 hypervascular foci within isointense hypovascular high-risk borderline lesions, 5 showed isointensity, and 9 hypointensity compared to the surrounding isointense hypovascular high-risk borderline lesions. No hypervascular foci showed hyperintensity compared to the surrounding isointense hypovascular high-risk borderline lesions.

Conclusions

In most of the hypovascular high-risk borderline lesions containing hypervascular foci within the nodule, the signal intensity was decreased in hypervascular foci as compared with hypovascular high-risk borderline lesions and the surrounding background liver parenchyma. This supports the concept of signal intensity decrease during the dedifferentiation process in multistep hepatocarcinogenesis. However, around 30 % of the nodules did not follow this rule, and hypervascular foci showed hyperintensity relative to the hypovascular high-risk borderline lesions.