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Appearance of hepatocellular adenomas on gadoxetic acid-enhanced MRI

  • Magnetic Resonance
  • Published:
European Radiology Aims and scope Submit manuscript

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.

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Authors and Affiliations

  1. Klinik für Radiologie, Campus Virchow-Klinikum, Charité–Universitätsmedizin Berlin, Augustenburger Platz 1, 13353, Berlin, Germany

    Timm Denecke, Ingo G. Steffen, Thomas Kröncke, Enrique Lopez Hänninen, Bernd Hamm & Christian Grieser

  2. Klinik für Allgemein, Viszeral- und Transplantationschirurgie, Campus Virchow-Klinikum, Charité–Universitätsmedizin Berlin, Berlin, Germany

    Daniel Seehofer & Peter Neuhaus

  3. Institut für Pathologie, Campus Virchow-Klinikum, Charité–Universitätsmedizin Berlin, Berlin, Germany

    Incken-Birthe Kramme

  4. Department of Radiology, Harvard Medical School and Massachusetts General Hospital, Boston, MA, USA

    Sheela Agarwal & Sanjay Saini

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  1. Timm Denecke
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Correspondence to Christian Grieser.

Additional information

The data were presented at the ESGAR and RSNA in 2011.

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Denecke, T., Steffen, I.G., Agarwal, S. et al. Appearance of hepatocellular adenomas on gadoxetic acid-enhanced MRI. Eur Radiol 22, 1769–1775 (2012). https://doi.org/10.1007/s00330-012-2422-5

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  • DOI: https://doi.org/10.1007/s00330-012-2422-5

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