Objective To investigate the value of new double-phasic MR contrast agent (gadobenate dimeglumine， Gd-BOPTA) in diagnosis of hepatocellular carcinoma (HCC) with correlation of pathology.
Methods MRI scan was performed on 33 patients suspected of having focal liver lesions by CT or ultrasonography. The MRI scan protocol included routine axial T1WI and T2WI, coronal T2WI and 3D-MRCP, Gd-BOPTA enhanced 3D gradient-echo sequence of T1W (LAVA sequence) acquiring dynamic data at 15 s, 55 s and 90 s respectively, delayed LAVA acquisition at 5 min, 10 min, and at 40 min, 80 min respectively. Surgical specimen was collected for pathological analysis.
Results Surgery confirmed the diagnosis of HCC in 21 patients with 27 lesions. The sensitivity, specificity and accuracy of MR imaging with combined phases (including hemodynamic phase and hepatobiliary phase) were 92.9%,93.3%, 92.9% respectively. ①In the hemodynamic phase: 22 lesions showed early enhancement in arterial phase, fast “washout” in portal venous phase, and hypointense in delayed phase. Four lesions showed slight enhancement, while 1 lesion showed no enhancement in all hemodynamic phases. ②In the hepatobiliary phase: 23 lesions showed homogeneous hypointensity compared to the enhanced liver background, but 4 lesions (3 well-differentiated and 1 moderately-differentiated) had patchy or dot-like slightly hyperintense areas scattered within the lesions. Pathologically cholestatic changes of tumor cells were observed and bile-containing small ducts were present.
Conclusion Gd-BOPTA enhanced MRI can both depict the hemodynamic characteristics and reflect the absence of normal hepatocyte function in HCC lesions, thus contributing greatly to the diagnosis of HCC.
Citation：
XU Jun,LI Yingchun,SONG Bin,JIANG Lili,YANG Yang,YIN Longlin,TANG Hehan,WU Bi. Value of Gd-BOPTA Enhanced MR in Diagnosing Hepatocellular Carcinoma with Correlation of Pathology. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2007, 14(4): 485-489. doi:
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- 1. Ichikawa T, Kitamura T, Nakajima H, et al. Hypervascular hepatocellular carcinoma: can double arterial phase imaging with multidetector CT improve tumor depiction in the cirrhotic liver? [Ｊ]. AJR Am J Roentgenol， 2002; 179(3)∶751.
- 2. 邬颖华， 宋彬， 徐隽, 等. VIBE序列在原发性肝癌诊断中的价值 [Ｊ]. 中国普外基础与临床杂志， 2005； 12（2）∶184.
- 3. Kirchin MA, Pirovano GP, Spinazzi A. Gadobenate dimeglumine (Gd-BOPTA). An overview [Ｊ]. Invest Radiol, 1998; 33(11)∶798.
- 4. Caudana R, Morana G, Pirovano GP, et al. Focal malignant hepatic lesions: MR imaging enhanced with gadolinium benzyloxypropionictetra-acetate (BOPTA)——preliminary results of phase Ⅱ clinical application [Ｊ]. Radiology， 1996; 199(2)∶513.
- 5. Vogl TJ, Stupavsky A, Pegios W, et al. Hepatocellular carcinoma: evaluation with dynamic and static gadobenate dimeglumine-enhanced MR imaging and histopathologic correlation [Ｊ]. Radiology, 1997; 205(3)∶721.
- 6. Pirovano G, Vanzulli A, Marti-Bonmati L, et al. Evaluation of the accuracy of gadobenate dimeglumine-enhanced MR imaging in the detection and characterization of focal liver lesions [Ｊ]. AJR Am J Roentgenol, 2000; 175(4)∶1111.
- 7. Kuwatsuru R, Kadoya M, Ohtomo K, et al. Comparison of gadobenate dimeglumine with gadopentetate dimeglumine for magnetic resonance imaging of liver tumors [Ｊ]. Invest Radiol, 2001; 36(11)∶632.
- 8. Hayashi M, Matsui O, Ueda K, et al. Progression to hypervascular hepatocellular carcinoma: correlation with intranodular blood supply evaluated with CT during intraarterial injection of contrast material [Ｊ]. Radiology, 2002; 225(1)∶143.
- 9. 陈卫霞， 闵鹏秋， 周翔平, 等. 肝细胞癌螺旋CT增强双期扫描边缘强化与病理对照研究 [Ｊ]. 中华放射学杂志， 2002； 36（2）∶152 .
- 10. 武忠弼， 杨光华主编. 中华外科病理学 [M]. 上卷. 第1版. 北京： 人民卫生出版社， 2002∶819~829.
- 11. Grazioli L, Morana G, Caudana R, et al. Hepatocellular carcinoma: correlation between gadobenate dimeglumine-enhanced MRI and pathologic findings [Ｊ]. Invest Radiol, 2000; 35(1)∶25.
