High-flow haemangiomas versus hypervascular hepatocellular carcinoma showing “pseudo-washout” on gadoxetic acid-enhanced hepatic MRI: value of diffusion-weighted imaging in the differential diagnosis of small lesions

Aim To validate the usefulness of diffusion-weighted imaging (DWI) in the differentiation of high-flow haemangiomas showing pseudo-washout appearance on gadoxetic acid-enhanced hepatic MRI from small hypervascular hepatocellular carcinomas (HCCs). Materials and methods DWI (b=50, 800 s/mm2 ) with ap...

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Bibliographic Details
Published in:Clinical radiology 2017-03, Vol.72 (3), p.247-254
Main Authors: Nam, S.J, Yu, J.-S, Cho, E.-S, Kim, J.H, Chung, J.-J
Format: Article
Language:English
Subjects:
Adult
Aged
Aged, 80 and over
Carcinoma, Hepatocellular - diagnostic imaging
Carcinoma, Hepatocellular - pathology
Contrast Media
Diffusion Magnetic Resonance Imaging - methods
Female
Gadolinium DTPA
Hemangioma - diagnostic imaging
Hemangioma - pathology
Humans
Image Enhancement - methods
Liver Neoplasms - diagnostic imaging
Liver Neoplasms - pathology
Magnetic Resonance Imaging - methods
Male
Middle Aged
Neovascularization, Pathologic - diagnostic imaging
Neovascularization, Pathologic - pathology
Radiology
Reproducibility of Results
Sensitivity and Specificity
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Summary:Aim To validate the usefulness of diffusion-weighted imaging (DWI) in the differentiation of high-flow haemangiomas showing pseudo-washout appearance on gadoxetic acid-enhanced hepatic MRI from small hypervascular hepatocellular carcinomas (HCCs). Materials and methods DWI (b=50, 800 s/mm2 ) with apparent diffusion coefficient (ADC) maps for 50 haemangiomas (6.4±2.9 mm) showing intense enhancement on arterial dominant phase imaging and hypointensity on transitional and/or hepatobiliary phase imaging during gadoxetic acid-enhanced MRI were retrospectively analysed and compared with that of 113 hypervascular HCCs (12.8±3.7 mm). In addition to measurement of mean ADC values on DWI and contrast-to-noise ratio (CNR) on corresponding T2-weighted imaging, qualitative analysis of DWI was performed for each lesion by two independent observers using a five-point scale. Results Both of mean ADC value (1.902 versus 0.997×10−3  mm2 /s) and mean CNR (119.2 versus 36.9) for haemangioma were significantly larger than for HCC ( p
ISSN:0009-9260
1365-229X
DOI:10.1016/j.crad.2016.09.020