Benefit of Double Contrast MRI in Diagnosis of
Hepatocellular Carcinoma in Patients with
Chronic Liver Diseases
Wanwarang Teerasamit MD*, Pairash Saiviroonporn PhD*,
Ananya Pongpaibul MD**, Pornpim Korpraphong MD*
Affiliation :
* Department of Radiology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
** Department of Pathology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
Objective : To assess the benefit on diagnosis of hepatocellular carcinoma (HCC) in patients with chronic liver disease or
cirrhosis with double contrast MR imaging compared to the routine gadolinium-based MR imaging.
Material and Method: Seventy-one consecutive patients with cirrhosis or chronic hepatitis underwent multiphase, gadolinium-
enhanced liver MRI examination and sequentially superparamagnetic iron oxide (SPIO)-enhanced images. The presence
signal intensities of lesions on non-contrast sequences, dynamic gadolinium-enhanced images and delayed 10-min post-SPIO
T2*-weighted images were recorded.
Results : Among 27 patients, 15 HCCs from 12 patients were diagnosed by surgical (n = 7) and non-surgical (n = 8) proofs.
The overall sensitivity, specificity, positive predictive value, and negative predictive value of double contrast-enhanced
images in 12 patients were 83.3% (95% CI: 58.5, 96.2), 33.3% (95% CI: 5.4, 88.4), 88.2% (95% CI: 63.5, 98.2), and 25%
(95% CI: 4.1, 79.6) and these of gadolinium-enhanced images were 72.2% (95% CI: 46.5, 90.2), 33.3% (95% CI: 5.4, 88.4),
86.6% (95% CI: 59.5, 97.9), and 16.6% (95% CI: 2.7, 63.9), respectively. There were two benign hepatic nodules (1 adenoma,
1 dysplastic nodule) suspected as HCCs on MR images and two surgically proven-HCCs, invisible on gadolinium-enhanced
images, detected as defect on only delayed 10-min post-SPIO T2*-weighted images.
Conclusion : SPIO-enhanced images in double contrast-enhanced MR imaging had an additional value on HCC detection,
compared to gadolinium-enhanced MR imaging, in patients with chronic liver disease or cirrhosis.
Keywords : Hepatocellular carcinoma, Chronic liver disease, Cirrhosis, Magnetic resonance imaging, SPIO, Double contrast
All Articles
Download