Hepatocellular Carcinoma: Dynamic Gadoliniumenhanced MR Imaging Findings And Its Correlation With Histopathologic Findings

Purpose To study the dynamic Gadolinium enhanced MR imaging findings of hepatocellular carcinoma and investigate its correlation with histopathologic findings.Materials and methods We studied thirty-five surgically and histologically proven HCCs. MR imaging examinations were performed on 1 .O-T IVIR imager using Tiweighted breath-hold FLASH images,turbo SE T2-weighted images and serial gadolinium-enhanced FLASH images.Images were analysized as following:lesion signal intensity during arterial phase(AP) and portal venous phase(PP); lesion enhancement degree on AP;lesion enhancement pattern on AP;tumor margin after enhancement and tumor capsule.Histologic parameters evaluated included:tumor cell differentiation;tumor tissue structure pattern .MR features were correlated with pathologic changes.Result The temporal dynamic enhancement type during AP and PP were as follows:type I:hyper- or iso-intensity on AP and hypo-intensity on PP;typell:hyper- or isointensity on both AP and PP;typelll:hypo-intensity on AP and iso- or hyper-intensity on PP,typelV:hypo-intensity on both AP and PP) In 35 HCCs, 19 showed type I and 12 type II,no type III and 4 type IV.The difference of tumor cell differentiation of dynimic enhancement types was statistically significant(p=O.007) ,the ratio of poorly differentiation HCCs in type I were statistically higher than other types(p=O.007),the ratio of well differetion HCCs in type II were statistically higher than other types(pz=O.O 1 1).In 35 HCCs, 15 showed trabecular structure ,6 pseudoglandular, 13 compact and 1 sclerosing . Compact and sclerosing HCCs mainly showed type I,trabecular and pseudoglandular HCCs showed type I and II . The difference of tumor cell differentiation of different enhancement degree HCCs on AP was not statistically significant ;but markedly enhanced HCCs tend to be poorly differentiated.Heterogenously enhanced HCCis predominant in the 35 HCCs .There is no Statistically siginificant correlation bCtweentumor margin after enhancement with tumor cell differentiation,bllt ill-defined HCCstend to be poorly differentiated.Tunor pseudocaPsule is best seen on equivalent phase.ConcIusion The temporal dynamic enhancement type of HCCs during AP and PP canreflect its tumor cell differelltiatiom and blood supply to some degree .MoSt HCCs of typeI were poorly differentiated and on1y have arteria1 blood supp1y, most HCCs of tyPe IIwere well differetiated and have both arterial and portal vein blood supply. The dynamicGadolinium enhanced MR imaging of hepatocellular carcinoma is helpful for predictingprognosis and chosing suitable treatmeflt.