Background & objective: Magnetic resonance imaging (MRI) is one of the main imaging diagnostic methods for primary hepatic cell carcinoma. This study was designed to summarize the MRI manifestation and to evaluate Gadolinium-diethylenetriaminepentaacetic acid (Gd-DTPA) and super paramagnetic iron oxide particles(SPIO) enhanced MRI in diagnosis of small hepatic carcinoma.
Materials & methods: Five hundreds patients diagnosed as primary hepatic cell carcinoma histologically were examined by MRI plain scan, plain scan + Gd-DTPA enhanced T1 weighted imaging, and plain scan + Gd-DTPA T1 weighted imaging + SPIO-enhanced heavy T2 weighted imaging was performed, respectively.
Results: In 500 patients, there were 65 (13.0%) small hepatic cell carcinoma, 81(16.2%) nodular lesions, 325 (65.0%) lump lesions; 29(5.8%) diffused lesions. 310(62%) patients were single lesion and the rest were multiple lesions. Twelve percent of the cases was associated with lymph nodes metastases, and 31.4% were complicated with vascular invasion. Diameter of the lesion was correlated positively to intro-hepatic metastases of the same or different lobe, the lymph nodes metastases and vascular invasion (P < 0.05). Totally 71 lesions were detected in the 65 cases with small hepatic carcinoma. Enhanced scan detected more lesions than plain scan (P < 0.05), and the lesions detected by Gd-DTPA + SPIO-enhanced scan were more than that by Gd-DTPA alone (P < 0.05).
Conclusion: With the diameter of the lesion increase, the possibility of intro-hepatic metastases, lymph node metastases, and vascular invasion increased. For the MRI diagnosis of small HCC, enhanced scan especially Gd-DTPA + SPIO enhanced scan could detect more lesions than plain scan.