The Value Of Diffusion-weighted Imaging And Dynamic Contrast Enhancement MRI In Differentiating Suspicious Small Hepatocellular Carcinoma

Part I The value of diffusion-weighted imaging and dynamic contrast enhancement MRI in differentiatingsuspicious small hepatocellular carcinomaObjective To compare the sensitivity of DWI and dynamic contrast enhancement MRI in differentiating SHCC,HAML,HCA ,and evaluate the clinical value for DWI.Materials and Methods:45 patients with 46 lesions (≤3cm)underwent DWI and 2D DCE MRI at the same time .The DWI was performed using ASSET technology with different b value (600,800sec/mm2). The dynamic MRI examination was performed using 2D FSPGR sequence.Two observers indepently interpreted the images in random order,separately.According to the ADC value of all lesions were calculated and analyzed statistically.Results All of 35 SHCC lesions showed as hyperintense on DWI, 4 HCA lesions were hyperintense on DWI.The mean ADC value of SHCC,HAML,HCA was 1.32±0.14×10-3mm2/s ,1.57±0.06×10-3mm2,1.95±0.10×10 -3mm2 /s respectively.There was statistically significant difference in ADC value between SHCC lesions and surrounding hepatic tissue(P=0.000), between HAML lesions and surrounding hepatic tissue(P=0.001), between HCA lesions and surrounding hepatic tissue(P=0.009),the accuracy of dynamic contrast enhancement in differentiating SHCC was 84.8%, the accuracy of DWI in differentiating SHCC was 90%, the combination of dynamic contrast enhancement and DWI had accuracy of 97.8% in differential diagnosis.Conclusion: combined with ADC value and signal features, DWI of liver can provide important information in differentiating SHCC from HDC and HAML. Part II The value of diffusion-weighted imaging and dynamic contrast enhancement MRI in differentiating hepatic cavernous hemangioma and Hepatic CystsObjective To compare the sensitivity of DWI and dynamic contrast enhancement MRI in differentiating hepatic cavernous hemangioma and hepatic Cysts and evaluate the clinical value for DWI.Materials and Methods:20 patients with20 lesions (≤3cm)underwent DWI and 2D DCE MRI at the same time .The DWI was performed using ASSET technology with different b value (600,800sec/mm2). The dynamic MRI examination was performed using 2D FSPGR sequence.Two observers indepently interpreted the images in random order,separately.According to the ADC value of all lesions were calculated and analyzed statistically.Results All of 12 hepatic cavernous hemangioma lesions showed as hyperintense on DWI, 8 hepatic Cysts lesions were hyperintense on DWI.The mean ADC value of was 2.20±0.18×10-3mm2 /s , 2.45±0.16×10-3mm2 /s respectively.There was statistically significant difference in ADC value between HCH lesions and surrounding hepatic tissue(P=0.001), between HC lesions and surrounding hepatic tissue(P=0.002). In accordance with Signal characteristics changes and lesion ADC values combined with the determination of the cyst and the differential diagnosis of hemangioma was 100% accurateConclusion: combined with ADC value and signal features, DWI of liver can provide important information in differentiating hepatic cavernous hemangioma and hepatic Cysts...