Characterizing Venous Vasculatures of Hepatocellular Carcinoma Using a Multi-Breath-Hold Two-Dimensional Susceptibility Weighted Imaging

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Abstract

The aim of our study is to characterize the venous vasculatures of hepatocellular carcinoma (HCC) using a multi-breath-hold two-dimensional (2D) susceptibility weighted imaging (SWI) in comparison with conventional Magnetic Resonance Imaging (MRI) sequences. Twenty-nine patients with pathologically confirmed HCC underwent MR examination at a 3.0 T scanner. The number of venous vascularity in or around the lesion was counted and the image quality was subjectively evaluated by two experienced radiologists independently based on four image sets: 1) SWI, 2) T1-weighted sequence, 3) T2-weighted sequence, and 4) T1-weighted dynamic contrast-enhanced (DCE) sequence. Of the 29 patients, a total of 33 liver lesions were detected by both SWI and conventional MR sequences. In the evaluation of the conspicuity of venous vascularity, a mean of 10.7 tumor venous vessels per mass was detected by the SWI and 3.9 tumor vasculatures were detected by T1-weighted DCE (P<0.0001), while none was detected by T1-, T2-weighted sequences. The Pearson correlation coefficients between the lesion sizes and the number of tumor vasculatures detected by T1-weighted DCE was 0.708 (P<0.001), and 0.883 by SWI (P<0.001). Our data suggest that SWI appears to be a more sensitive tool compared to T1-weighted DCE sequence to characterize venous vasculature in liver lesions. © 2013 Chang et al.

Figures

  • Figure 1. MR images of a 59-year-old man with a solitary HCC. a: no obvious tumor vasculature is visible in the axial T1-weighted imaging or b: the axial T2-weighted imaging; c: the contrast-enhanced axial T1-weighted image shows the mass with irregularly enhancement and no obvious tumor veins were detected; d: noncontrast-enhanced SWI shows considerably more detail of the internal architecture than T1-weighted DCE. Scattered linear hypointense signals (arrows) suggest radiating veins in the centre of the mass. doi:10.1371/journal.pone.0065895.g001
  • Figure 2. A case of a 72-year-old man with HCC. a, b, and c correspond to T1 precontrast, the axial T2-weighted imaging, and T1weighted DCE, respectively; d: axial non-contrast SWI indicates intratumorally linear vasculatures or curved cylindrical tubeshaped structures with clear boundaries (arrows).
  • Table 1. The levels of interobserver variability in quantitative analysis of tumor veins determined on both T1-weighted DCE and Non-contrast-enhanced SWI.
  • Table 2. The number of tumor veins per HCC mass detected on both CE-T1 and SWI sequences for both observers.
  • Figure 3. Correlations between the lesion maximum size and tumor venous vasculatures detected on contast-enhanced T1weighted imaging (a) and on SWI (b) (P,0.001 for all). doi:10.1371/journal.pone.0065895.g003

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Chang, S. X., Li, G. W., Chen, Y., Bao, H., Zhou, L., Yuan, J., … Dai, Y. M. (2013). Characterizing Venous Vasculatures of Hepatocellular Carcinoma Using a Multi-Breath-Hold Two-Dimensional Susceptibility Weighted Imaging. PLoS ONE, 8(6). https://doi.org/10.1371/journal.pone.0065895

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