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Triple Arterial Phase Dynamic MRI with Sensitivity Encoding for Hypervascular Hepatocellular Carcinoma: Comparison of the Diagnostic Accuracy Among the Early, Middle, Late, and Whole Triple Arterial Phase Imaging

Kensaku Mori1, Hiroshi Yoshioka2, Nobuyuki Takahashi1, Masayuki Yamaguchi1, Teruko Ueno1, Toshihiro Yamaki3 and Yukihisa Saida4

1 Department of Radiology, Institute of Clinical Medicine, University of Tsukuba, Tennodai 1-1-1, Tsukuba, Ibaraki 305-8575, Japan.
2 Department of Radiology, Brigham and Women's Hospital, Boston, MA 02115.
3 Department of Radiology, Asahikawa Medical College, Asahikawa 078-8510, Japan.
4 Department of Diagnostic Imaging, National Hospital Organization Mito Medical Center, Mito, Ibaraki 311-3117, Japan.



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  		Fig. 1A. —53-year-old man with solitary hepatocellular carcinoma. All MR images shown were obtained using sensitivity encoding technique. Transverse unenhanced T1-weighted fast-field-echo MR image (TR/TE/flip angle, 168/4.6/70) shows hypointense tumor measuring 45 mm in diameter in segment VII.

 


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  		Fig. 1B. —53-year-old man with solitary hepatocellular carcinoma. All MR images shown were obtained using sensitivity encoding technique. Transverse gadolinium-enhanced early, middle, and late arterial phase T1-weighted fast-field-echo MR images (TR/TE/flip angle, 168/4.6/70) show early enhancement of tumor, which is most apparently observed in middle arterial phase image (C).

 


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  		Fig. 1C. —53-year-old man with solitary hepatocellular carcinoma. All MR images shown were obtained using sensitivity encoding technique. Transverse gadolinium-enhanced early, middle, and late arterial phase T1-weighted fast-field-echo MR images (TR/TE/flip angle, 168/4.6/70) show early enhancement of tumor, which is most apparently observed in middle arterial phase image (C).

 


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  		Fig. 1D. —53-year-old man with solitary hepatocellular carcinoma. All MR images shown were obtained using sensitivity encoding technique. Transverse gadolinium-enhanced early, middle, and late arterial phase T1-weighted fast-field-echo MR images (TR/TE/flip angle, 168/4.6/70) show early enhancement of tumor, which is most apparently observed in middle arterial phase image (C).

 


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  		Fig. 1E. —53-year-old man with solitary hepatocellular carcinoma. All MR images shown were obtained using sensitivity encoding technique. Transverse gadolinium-enhanced portal phase T1-weighted fast-field-echo MR image (TR/TE/flip angle, 168/4.6/70) shows tumor as sligthtly hypointense area.

 


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  		Fig. 1F. —53-year-old man with solitary hepatocellular carcinoma. All MR images shown were obtained using sensitivity encoding technique. Transverse gadolinium-enhanced equilibrium phase T1-weighted fast-field-echo MR image (TR/TE/flip angle, 168/4.6/70) shows tumor as hypointense area.

 


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  		Fig. 1G. —53-year-old man with solitary hepatocellular carcinoma. All MR images shown were obtained using sensitivity encoding technique. Transverse unenhanced T2-weighted turbo spin-echo MR image (TR/TE/flip angle, 1800/90) shows tumor as hyperintense area.

 


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  		Fig. 1H. —53-year-old man with solitary hepatocellular carcinoma. All MR images shown were obtained using sensitivity encoding technique. Transverse CT during hepatic arteriography image shows enhancement of tumor.

 


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  		Fig. 1I. —53-year-old man with solitary hepatocellular carcinoma. All MR images shown were obtained using sensitivity encoding technique. Transverse CT during arterial portography image shows portal perfusion defect due to tumor.

 


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  		Fig. 1J. —53-year-old man with solitary hepatocellular carcinoma. All MR images shown were obtained using sensitivity encoding technique. Transverse CT scan after chemoembolization shows dense accumulation of iodized oil in tumor.

 

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