Conspicuity of hepatocellular nodular lesions in cirrhotic livers at ferumoxides-enhanced MR imaging: Importance of Kupffer cell number

PURPOSE: To correlate the conspicuity of hepatocellular carcinomas and dysp lastic nodules on ferumoxides-enhanced magnetic resonance (MR) images with the number of Kupffer cells in the hepatic lesions, as compared with that i n background liver in histopathologic findings. MATERIALS AND METHODS: Sixty-nine histopathologically proved moderately or poorly differentiated hepatocellular carcinomas, 10 well-differentiated hep atocellular carcinomas, and 19 dysplastic nodules were retrospectively stud ied in 68 patents with cirrhosis who underwent ferumoxides-enhanced MR imag ing. The contrast-to-noise ratio between the nodules and surrounding parenc hyma was calculated at T2-weighted fast spin-echo imaging, and the differen ce in the number of Kupffer cells between the nodules and surrounding hepat ic tissue was calculated histopathologically. The results of MR imaging and histopathologic examination were correlated. RESULTS: All 69 moderately or poorly differentiated hepatocellular carcinom as had high contrast-to-noise ratios at MR imaging and large differences in the number of Kupffer cells. Six of the 10 well-differentiated hepatocellu lar carcinomas had contrast-to-noise ratios of zero or nearly zero, and fiv e of these had little difference in the number of Kupffer cells. All 19 dys plastic nodules had contrast-to-noise ratios of zero or nearly zero, and th ere were virtually no differences in the number of Kupffer cells. CONCLUSION: Hepatocellular nodule conspicuity at ferumoxides-enhanced MR im aging depends on differences in the number of Kupffer cells within a nodule and the surrounding cirrhotic liver; moderately or poorly differentiated h epatocellular carcinomas can be distinguished from well-differentiated hepa tocellular carcinomas and dysplastic nodules.