MR hepatic arteriography and MR arterial portography for assessment of hepatocellular carcinoma. Comparison with CT

The purpose of this study was to document the usefulness of MR imaging hepatic arteriography (MRHA) and MR imaging arterial portography (MRAP) against CT hepatic arteriography (CTHA) and CT arterial portography (CTAP) in the diagnosis and assessment of hepatocellular carcinoma. In addition to CTHA and CTAP (Angio-CT), MRHA and MRAP (Angio-MRI) were performed immediately after hepatic angiography. This was done through contrast material injection into intra-arterially placed catheters (CTHA: common hepatic artery, CTAP: superior mesenteric artery) in 22 patients with nodular hepatocellular carcinoma. The diagnostic capability of CTHA or MRHA alone, CTAP or MRAP alone, combined CTHA and CTAP (CTHA-CTAP), or combined MRHA and MRAP (MRHA-MRAP) were evaluated by three radiologists on a segment by segment basis. Diagnostic accuracy was assessed with receiver operating characteristic (ROC) analysis. The accuracy (Az values) of the techniques were: CTHA (0.9250), CTAP (0.9219), CTHA-CTAP (0.9400), MRHA (0.9408), MRAP (0.9421), and MRHA-MRAP (0.9479). Sensitivity (%)/specificity (%)/PPV (%) was: CTHA (81/93/82), CTAP (82/93/82), CTHA-CTAP (87/95/87), MRHA (81/93/82), MRAP (90/94/85), and MRHA-MRAP (89/95/87). The differences in Az values, sensitivity, specificity, and PPV between Angio-CT and Angio-MRI were not statistically significant. In conclusion, MRHA and MRAP showed equal diagnostic effectiveness when compared with CTHA and CTAP. Therefore, MRHA and MRAP were found to be potentially useful in the diagnosis and assessment of hepatocellular carcinoma. (author)