Đặc điểm hình ảnh và giá trị của cộng hưởng từ trong chẩn đoán ung thư gan nguyên phát ≤ 3 cm ở bệnh nhân xơ gan

Imaging characteristics and values of MRI for diagnosis of hepatocellular carcinoma ≤ 3cm in cirrhotic patients

SUMMARY

Purpose: To describe the MR imaging features and to evaluate values of MRI for diangosis of hepatocellular carcinomas ≤ 3cm in cirrhotic patients.

Materials and methods: 35 patients with final diagnosis of hepatocellular carcinoma (HCC)≤ 3cm undergone MRI 1.5 Tesla at Radiology Departement (Bach MaiHospital) from August 2014 to July 2015.

Results: The average diameter was 21.14mm, all were solitary, most of tumor locate in right liver. Among 35 tumors detected: 100% was hyperintense on Diffusion; 97.1% hyperintense on T2W; on inphase T1W 11.4% hyperintense, 57.2% hypointense, 31.4% isointense; on outphase T1W 2.9% hyperintense, 82.8% hypointense, 14.3% isointense; 40% tumors have fatty content inside. After contrast gadolium injection, at the arterial phase 71.4% of tumors showed enhancement; at the portal phase 48.57% of tumors showed contrast wash out; at the late phase 68.6% of tumors had contrast wash out and 68.6% of tumors had a rim enhancement. MRI dectected 100% of tumors and diagnosed 54.3% of tumors based on the characteristic arterial contrast enhancement and portal or late phase contrast washout. The combination of ≥3 or ≥4 morphological and hemodynamic signs could increase the diagnostic sensitivity to 91.4% and 60% respectively.

Conclusion: Among 35 HCCs ≤ 3cm in cirrhotic livers: 97.1% and 100% appeared hyperintense on T2W and Diffusion respectively, most tumors were hyposignal on outphase T1W, 40% had fatty content. After gadolium contrast injection, 71.4% tumors had arterial contrast enhancement, 68.6% tumors showed portal or late contrast washout, 68.6% had rim enhancement. MRI detected 100% tumors and diagnosed 54.3% of all tumors.

Keywords: Hepatocellular carcinoma, HCC, cirrhosis, MRI.