The purpose of this study was to document the additional value of MR imagin
g during arterial portography (MRAP) in patients examined with intravenous
contrast-enhanced dynamic MR imaging for the assessment of focal lesions in
patients with cirrhosis or chronic viral hepatitis. The MR images of 24 pa
tients with 39 hepatocellular carcinomas and 18 benign hepatocellular nodul
es examined with dynamic MR imaging and MRAP within a Iri-day interval were
retrospectively reviewed. For 39 hepatocellular carcinomas, MRAP revealed
37 perfusion defects (95%), while dynamic MR imaging demonstrated 35 occurr
ences of nodular contrast-enhancement (90%) on arterial dominant phases. Am
ong the ii benign nodules misinterpreted as hepatocellular carcinoma due to
their high signal intensities on arterial-dominant phases of dynamic MR im
aging, eight (73%) showed intratumoral portal venous perfusion on MRAP and
were regarded as benign nodules. As a result of its high sensitivity and it
s potential ability to enable differentiation of benign and malignant hepat
ocellular nodules, MRAP can be added to dynamic MR imaging for planning fut
ure management in patients with equivocal hepatocellular nodules in the cir
rhotic liver.