HEPATOCELLULAR-CARCINOMA IN CIRRHOTIC LIVERS - DETECTION WITH UNENHANCED AND IRON OXIDE-ENHANCED MR-IMAGING

PURPOSE: To evaluate diagnostic accuracy with unenhanced and superpara magnetic iron oxide (SPIO)-enhanced magnetic resonance (MR) imaging fo r detection of hepatocellular carcinoma (HCC) in cirrhotic livers. MAT ERIALS ANL) METHODS: Fifteen patients with 26 histologically proved HC Cs associated with liver cirrhosis underwent imaging with T1-, T2-, an d proton-density-weighted spin-echo (SE) and fast low-angle shot (FLAS H) sequences. Lesion-to-liver contrast-to-noise ratios were measured i n all sequences. Diagnostic performance of the imaging techniques was assessed by using receiver operating characteristic analysis. RESULTS: Enhanced SE and FLASH sequences were significantly more accurate (P < .005) for the detection of small HCCs. Among the unenhanced pulse sequ ences, the accuracy of tumor localization was highest with the T2-weig hted SE sequences; however, 25% of the lesions were located incorrectl y. Compared with unenhanced images, lesions were correctly located mor e often when SPIO-enhanced SE and FLASH sequences were used. CONCLUSIO N: SPIO-enhanced MR imaging with proton-density-weighted or FLASH sequ ences was more accurate in the detection of small HCCs in cirrhotic li vers.