FOCAL NODULAR HYPERPLASIA OF THE LIVER - ASSESSMENT OF HEMODYNAMIC AND ANGIOARCHITECTURAL PATTERNS WITH GADOLINIUM CHELATE-ENHANCED 3D SPOILED GRADIENT-RECALLED MRI AND MAXIMUM INTENSITY PROJECTION REFORMATTEDIMAGES

Purpose: Our goal was to determine the relative merits of gadolinium c helate-enhanced 3D spoiled gradient-recalled (GRE) MRI versus maximum intensity projection (MIP) reformatted images in assessing the morphol ogic, hemodynamic, and angioarchitectural patterns of focal nodular hy perplasia (FNH) of the liver. Method: Ten consecutive patients with 10 FNHs had prospectively gadolinium chelate-enhanced 3D spoiled GRE MRI (TR/TE/FA = 10.1/1.9/30) of the liver at 1.5 T. Gadolinium chelate-en hanced 3D spoiled GRE source images and MIP reformatted images were se parately analyzed with respect to morphologic and hemodynamic features and angioarchitectural patterns by two independent readers. Results: Gadolinium chelate-enhanced 3D spoiled GRE source images and MIP refor matted images showed the most intense degrees of enhancement of FNH du ring the arterial phase of hepatic parenchymal enhancement in all case s, Gadolinium chelate-enhanced 3D spoiled GRE source images were super ior to MIP reformatted images for the assessment of morphologic featur es of FNH (p < 0.02). MIP reformatted images were superior to the corr esponding source images for showing the main branches of the hepatic a rtery, an arterial branch going to the FNH, and a small artery within the FNH radiating to peripheral areas (p < 0.05). There was excellent agreement between the two observers for analysis of the MIP reformatte d images (p < 0.05). Conclusion: The combination of gadolinium chelate -enhanced 3D spoiled GRE source images and MIP reformatted images allo ws the analysis of morphologic, hemodynamic, and angioarchitectural pa tterns of FNH of the liver. Further study and comparison with currentl y applied strategies will determine the value of these two techniques for diagnosing FNH of the liver.