Identification of Arterial Hyperenhancement in CT and MRI in Patients with Hepatocellular Carcinoma: Value of Unenhanced Images.
OBJECTIVE
According to the current guidelines, arterial hyperenhancement for diagnosis of hepatocellular carcinoma (HCC) is determined using the arterial phase only. We investigated the optimal definition of arterial hyperenhancement in patients with HCC using computed tomography (CT) and magnetic resonance imaging (MRI).


MATERIALS AND METHODS
The Institutional Review Board approved this retrospective study. The requirement for informed consent was waived. Between January 2011 and September 2013, 147 consecutive patients with surgically proven HCCs with both pre-operative CT and MRI were included. Identification rates of arterial hyperenhancement on CT and magnetic resonance (MR) images using arterial phase only, dual phase (unenhanced and arterial phases), and also subtraction MR images were assessed qualitatively.


RESULTS
The identification rates for arterial hyperenhancement on CT were significantly different between arterial phase and dual phase (72.8% vs. 90.5%; p < 0.001), whereas the rates were similar on MRI (91.8% vs. 93.9%; p = 0.257). The identification rate of arterial hyperenhancement in MRI increased to 98.6% using subtraction MR images.


CONCLUSION
Visual comparison of arterial and unenhanced phases could be recommended instead of conventional qualitative arterial phase alone assessment to determine arterial hyperenhancement of HCCs, especially when using CT.
['Kim|Mimi|M|0000-0002-8266-0226', 'Kang|Tae Wook|TW|0000-0002-0725-8317', 'Cha|Dong Ik|DI|', 'Jang|Kyoung Mi|KM|', 'Kim|Young Kon|YK|', 'Kim|Seong Hyun|SH|', 'Sinn|Dong Hyun|DH|', 'Kim|Kyunga|K|']
D000328:Adult D000368:Aged D000369:Aged, 80 and over D006528:Carcinoma, Hepatocellular D003287:Contrast Media D005260:Female D019786:Gadolinium DTPA D006801:Humans D007089:Image Enhancement D008099:Liver D008113:Liver Neoplasms D008279:Magnetic Resonance Imaging D008297:Male D008875:Middle Aged D012189:Retrospective Studies D014057:Tomography, X-Ray Computed
Hepatocellular carcinoma Diagnosis Computed tomography Magnetic resonance imaging Arterial enhancement Contrast Dynamic imaging