Natural history of small hepatocellular carcinoma: studied by MRI / 中华肿瘤杂志

<p><b>OBJECTIVE</b>To study natural history of small hepatocellular carcinoma (sHCC) and value of MRI in this research.</p><p><b>METHODS</b>From 1999 to 2002, serial MR imagings were performed in 192 patients with cirrhosis no less than twice in order to detect sHCC focus. Characteristic MRI findings of focus were analysed. Diameters of focus (D) were measured. Tumorigenesis detected time (T) was counted; T and D were analysed by statistics and tumor volume doubling time (T(d)) was calculated.</p><p><b>RESULTS</b>Fifty-eight new tumor foci in 33 patients were found, including 31 foci in 23 patients developed on the basis of cirrhosis, with a 12.0% cumulative tumorigenic rate of three years. The tumorigenesis detected time (T) was 386.9 +/- 256.4 days and the maximum diameter (D) was 2.258 +/- 1.074 cm. T was statistical correlated with D(3) (P < 0.01) and regressive formulas were established: D(3) = -2.69 + 0.058T (P = 0.0007), D(3) = -72.13 + 16.04lnT (P = 0.0064). Tumor volume doubling time was 20 approximately 279 days (mean: 104 days).</p><p><b>CONCLUSION</b>The percentage of tumorigenesis is high in patients with cirrhosis. Regular MRI examinations are necessary to detect sHCC early. The optimal interval time is 3 approximately 6 months.</p>

Clinical value of MR cholangiopancreatography combining with dynamic enhanced MRI in the detection of cholangiocarcinoma / 中华肝脏病杂志

<p><b>OBJECTIVES</b>To evaluate the clinical value of breath-hold magnetic resonance cholangiopancreatography (MRCP) combining with dynamic enhanced MRI in the diagnosis of cholangiocarcinoma.</p><p><b>METHODS</b>MRCP findings of 88 cholangiocarcinoma patients proved surgically and pathologically were analyzed retrospectively.</p><p><b>RESULTS</b>MRCP examination succeeded in all the 88 patients and the pancreaticobiliary ducts were shown satisfactorily. The accuracy of MRCP in the location of both hilar and extrahepatic cholangiocarcinoma was 100%, and the accuracy of detecting hilar and extrahepatic cholangiocarcinoma were 100% and 52.2%, respectively. Combining with dynamic enhanced MRI, the detecting accuracy of extrahepatic cholangiocarcinoma improved to 91.3%.</p><p><b>CONCLUSIONS</b>MRCP examination has a high successful rate and can accurately determine the location of hilar and extrahepatic cholangiocarcinoma, and the accuracy of qualitative diagnosis for the former two is high. Combining with dynamic enhanced MRI, the specificity of determining extrahepatic cholangiocarcinoma is also high.</p>

Three-dimensional contrast-enhanced MR angiography in diagnosis of cerebral arteriovenous malformation / 中华放射学杂志

Objective To evaluate the value of three-dimensional contrast-enhanced angiography (3D CE MRA) and MRI in the diagnosis and delineation of cerebral arteriovenous malformation(AVM). Methods Twenty-two cases of cerebral AVM examined by MRI and 3D CE,MRA.DSA was performed in 17 cases.A three-dimensional fast low angle shot (3D FLASH) was used for 3D CE MRA with Gd-DTPA dosage of 0.2 mmol per kilogram for body weight.The source images were subtracted from mask images and transferred to computer workstation using three-dimensional reconstruction.Results Among 22 cases, 19 showed typical AVM“flow void”signal on MR images.3D CE MRA clearly displayed the nidus,feeding artery and draining vein.All of the foci were above the cerebellum tentorium.13 located within one lobe, 3 exceeded one lobe and 3 situated in the deep of cerebrum.Feeding arteries were derived from single artery in 9 cases,and mixed supply in 10 cases.Draining veins diverted to sagittal sinus and/or sigmoid sinus in 6,deep cerebral veins in 8 and mixed in 5.In the 14 cases examined by both DSA and 3D CE MRA,3D CE MRA was superior to DSA in three-dimensional demonstration of the nidus,but inferior to DSA in demonstration of some details.3D CE MRA depicted 78.4% feeding arteries and 84.0% draining veins in addition,tiny pathologic blood vessels smaller than 1 centimeter were detected by DSA,but could not be found by 3D CE MRA and were only shown as hemorrhage lesions on MR images in 3 cases.Conclusion As a non-invasive technique,3D CE MRA combined with MRI is accurate in diagnosis and localization of cerebral AVM,and should be used as the first choice for those clinically suspected of AVM.But DSA remains needed for demonstration of details and tiny AVM.