MR imaging during arterial portography for assessment of hepatocellular carcinoma: comparison with CT during arterial portography.

Abstract

The purpose of this study was to document the usefulness of MR imaging during arterial portography (MRAP) versus CT during arterial portography (CTAP) in the diagnosis and assessment of hepatocellular carcinoma. In addition to static T1- and T2-weighted MR imaging, MRAP was performed immediately after hepatic angiography through contrast material injection into intraarterially placed catheters (superior mesenteric or splenic artery) in 21 patients with nodular hepatocellular carcinoma. CTAP was performed afterward for each patient. The sensitivity and specificity of MRAP for lesion detection and the differential diagnosis of hepatocellular carcinoma were compared with the sensitivity and specificity of CTAP. MRAP revealed more perfusion defects (n = 56) than did CTAP (n = 46). The sensitivity for detection of hepatocellular carcinoma was higher for MRAP (94%) than for CTAP (83%); however, the difference was not statistically significant (p > .05). More hepatocellular nodules with unknown malignant potential were revealed on MRAP (n = 7) than on CTAP (n = 2). For the differential diagnosis of perfusion defects commonly revealed by both techniques, more benign lesions and pseudolesions (n = 14) were shown on MRAP through the combined interpretation with static images than on unenhanced and contrast-enhanced CTAP (n = 11). Because of its high sensitivity and its ability to enable radiologists to differentiate benign from malignant conditions, MRAP may have merit compared with CTAP in the assessment of hepatocellular carcinoma.