• Satoshi Kobayashi, Osamu Matsui, Toshifumi Gabata, Wataru Koda, Tetsuya Minami, Yasuji Ryu, Kazuto Kozaka, and Azusa Kitao.
• Dept of Radiology, Kanazawa University School of Medicine, 13-1, Takara Machi, Kanazawa 920-8641, Japan. satoshik@staff.kanazawa-u.ac.jp
• Eur J Radiol. 2012 Dec 1; 81 (12): 3839-45.

ObjectivesTo analyze intranodular signal intensity pattern of hypovascular high-risk borderline lesions of HCC that illustrate multi-step hepatocarcinogenesis within the nodule on Gd-EOB-DTPA-enhanced MRI.MethodsA total of 73 nodules showing hypervascular foci in hypovascular high-risk borderline lesions identified by angiography-assisted CT were included in this study. The intranodular signal intensities of both the hypervascular foci and the hypovascular high-risk borderline lesions were evaluated on hepatobiliary-phase EOB-enhanced MRI obtained 20 min after intravenous injection of contrast media.ResultsAmong 59 hypervascular foci within hypointense hypovascular high-risk borderline lesions, 6 showed more hypointensity, 32 isointensity, and 21 hyperintensity compared to the surrounding hypointense, hypovascular portion of the nodules. Among 14 hypervascular foci within isointense hypovascular high-risk borderline lesions, 5 showed isointensity, and 9 hypointensity compared to the surrounding isointense hypovascular high-risk borderline lesions. No hypervascular foci showed hyperintensity compared to the surrounding isointense hypovascular high-risk borderline lesions.ConclusionsIn most of the hypovascular high-risk borderline lesions containing hypervascular foci within the nodule, the signal intensity was decreased in hypervascular foci as compared with hypovascular high-risk borderline lesions and the surrounding background liver parenchyma. This supports the concept of signal intensity decrease during the dedifferentiation process in multistep hepatocarcinogenesis. However, around 30% of the nodules did not follow this rule, and hypervascular foci showed hyperintensity relative to the hypovascular high-risk borderline lesions.Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

30 keywords...

hide…