Evaluation of dynamic magnetic resonance imaging during arteriography using gadopentetate dimeglumine for the detection of hepatocellular carcinoma

Dynamic magnetic resonance (MR) imaging during arteriography using Gd-DTPA was performed to evaluate its clinical usefulness in 12 patients with 14 hepatocellular carcinoma confirmed by CT, angiography, and high serum AFP level or fine-needle biopsy. After conventional hepatic arteriography, the patients were transferred to the MR unit and MR imaging during arteriography was obtained with the gradient-echo technique synchronously starting manual injection of Gd-DTPA diluted with normal saline via the hepatic artery using 5-F Cobra angiographic catheter. The scan time was 24 or 26 seconds and 4 or 6 slice-section images of the arterial phase were acquired during a single breath-hold. The tumors showed iso or low signal intensity on the precontrast images, but were revealed a high signal intensity area relative to surrounding normal parenchyma during the arterial phase and a clear liver-to-lesion contrast was acquired. Especially in two cases which had been treated, the local recurrence was not detected on the conventional angiographic examination but was visualized as a high signal intensity area on MR imaging during arteriography. In addition to other two cases, fan-shaped enhancement was seen by the tumor suggesting the presence of an arterio-portal shunt. This new technique seemed to be useful for regional detection of hepatocellular carcinomas obtaining in the optional plane and for accurate estimating the local recurrence and an arterio-portal shunt. (author)