Double arterial phase dynamic MRI with sensitivity encoding (SENSE) for hypervascular hepatocellular carcinomas

Abstract

Purpose: To investigate the efficacy of SENSE MRI, including the double arterial phase dynamic study, to detect hypervascular hepatocellular carcinomas (HCCs). Materials and Methods: MRI of the liver was performed in 40 consecutive patients (20 by conventional MRI and 20 by SENSE MRI). The SENSE technique was used to obtain breath-hold T1-weighted FSE images (TR/TE = 556/12 msec), respiratory-triggered T2-weighted FSE images (TR/TE = 1800/90 msec) with and without fat suppression, and dynamic MR images (TR/TE/FA = 160-168/4.6 msec/70°). In each arterial dominant phase and portal dominant phase, two scans were consecutively performed with one breath-hold, leading to the double arterial phase and double portal phase images with SENSE. Results: The sensitivity of SENSE MRI for HCCs diagnosed from all MR images, including dynamic study, T1-weighted images, and T2-weighted images, was 91.7%, while that of conventional MRI was 76.3%. The positive predictive value of SENSE MRI for HCCs was 91.7%, while that of conventional MRI was 87.9%. In terms of HCCs ≤ 10 mm, the sensitivity and positive predictive values of SENSE MRI were 78.6% and 78.6%, respectively, while those of conventional MRI were 27.3% and 60.0%, respectively. The number of detected HCCs ≤ 10 mm was significantly larger in SENSE MRI than in conventional MRI (P < 0.05). The cause of false-positive lesions on SENSE MR images was an arterioportal shunt. Conclusion: SENSE MRI with double arterial phase dynamic study showed higher sensitivity compared to the conventional technique. Therefore, SENSE MRI is a promising method for the detection of HCC. © 2002 Wiley-Liss, Inc.