Susceptibility-Weighted Imaging for the Noncontrast Evaluation of Hepatocellular Carcinoma: A Prospective Study with Histopathologic CorrelationReport as inadecuate




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Background

Specific morphologic features of hepatocellular carcinoma HCC on imaging have identifiable pathologic correlates as well as implications for altering surgical management and defining prognosis. In this study, we compared susceptibility-weighted imaging SWI to conventional techniques and correlated our findings with histopathology to determine the role of SWI in assessing morphologic features of HCC without using a contrast agent.

Methods

86 consecutive patients with suspected HCC were imaged with MRI including T1, T2, T2*, and SWI and subsequently CT. 59 histologically-proven HCC lesions were identified in 53 patients. Each lesion on each imaging sequence was evaluated by two radiologists, and classified with respect to lesion morphology, signal intensity relative to surrounding hepatic parenchyma, presence of a pseudocapsule, presence of venous invasion, and internal homogeneity.

Results

Histopathology confirmed pseudocapsules in 41-59 lesions. SWI was able to detect a pseudocapsule in 34-41 lesions; compared to conventional T1-T2 imaging 12-41 and T2* 27-41. Mosaic pattern was identified in 25-59 lesions by histopathology; SWI confirmed this in all 25 lesions, compared to T1-T2 imaging 13-25 or T2* 18-25. Hemorrhage was confirmed by histopathology in 43-59 lesions, and visible on SWI in 41-43 lesions, compared to T1-T2 7-43 and T2* 38-43. Venous invasion was confirmed by histopathology in 31-59 patients; SWI demonstrated invasion in 28-31 patients, compared to T1-T2 7-31 and T2* 24-31.

Conclusions

SWI is better at identifying certain morphologic features such as pseudocapsule and hemorrhage than conventional MRI without using a contrast agent in HCC patients.



Author: Wei Chen, Zachary DelProposto, Wei Liu, Mohammad Kassir, Zhiyuan Wang, Jun Zhao, Bing Xie, Yaming Wen, Jian Wang , Jiani Hu

Source: http://plos.srce.hr/



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