CT and MRI findings of the portal flow disturbance with malignant hepatic tumors, including the utility of MRI with AMI-25

Four patients with portal flow disturbances were studied with Computed Tomography and Magnetic Resonance Imaging. Three patients had hepatocellular carcinoma (HCC) with liver cirrhosis, and one patient had gastric carcinoma with hepatic metastases and portal thrombosis. Precontrast CT showed two affected regions as hypodensities but other two as isodensities. Bolus helical CT during arterial dominant phase showed two affected regions as peripheral wedge-shaped hyperdensities, while remaining two cases had no regional enhancement. Delayed phase CT showed three regions as isodensities. MRI without contrast material showed two regions as hypointensities on T1-weighted images and three regions as hyperintensities on T2-weighted images. Both T1- and T2-weighted MR images with superparamagnetic iron oxide (AMI-25) showed diminished signal intensities of those regions with portal flow disturbance except for one case with HCC. Bolus helical CT and T2-weighted MR images are sensitive to detect abnormalities with segmental portal flow disturbance, and AMI-25 is helpful to distinguish those segmental abnormalities from hepatic neoplasms. (author)