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Objective Compared with digital subtraction angiography(DSA),to evaluate the value of high-resolution contrast-enhanced three-dimensional magnetic resonance angiography(3D MRA) in defining hepatic arterial anatomy.Methods The data about abdominal high-resolution contrast-enhanced 3D MRA and DSA of 26 patients (24 patients with primary liver cancer,2 patients with metastatic liver tumor) was retrospectively analyzed.The display quality of different segmental hepatic artery was scored with 4 grades and the agreement between high-resolution 3D MRA and DSA was determined with the weighted Kappa statistic.The depiction of hepatic arterial anatomy/anomalies and vascular pathology on high- resolution 3D MRA was assessed and compared with DSA.Results With respect to display quality,there was good or fair correlation between high-resolution 3D MRA and DSA for the common hepatic artery (the mean score respectively was 3.96,3.96 and Kappa value 0.99),gastroduodenal artery (the mean score respectively 3.85,3.88 and Kappa value 0.85 ),right hepatic artery(the mean score respectively 3.92, 3.96 and Kappa value 0.65 ),left hepatic artery (the mean score respectively 3.77,3.92 and Kappa value 0.43 ),left gastric artery(the mean score respectively 3.73,3.85 and Kappa value 0.43 ),right anterior artery (the mean score respectively 3.35,3.70 and Kappa value 0.53),right posterior artery (the mean score respectively 3.31,3.73 and Kappa value 0.46)and 1V segment artery (the mean score respectively 2.92,3.46 and Kappa value 0.51 );Poor correlation was found for the Ⅱsegment artery (the mean score respectively 2.15,3.35 and Kappa value 0.18)and Ⅲsegment artery (the mean score respectively 2.19, 3.35 and Kappa value 0.21 ).Compared with DSA,18 normal hepatic arterial anatomy and 7 arterial anomalies were accurately demonstrated(accuracy ratio 96.1% (25/26)),the obliteration of gastroduodenal artery correctly depicted in 1 patient on high-resolution 3D MRA image.Conclusions High-resolution 3D MRA can provide accurate evaluation of hepatic artery and has the capacity of depicting hepatic segment artery.
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Objective To analyze and compare the imaging features of chromophobe cell renal carcinoma(CCRC)with pathologic findings in order to improve the diagnostic accuracy.Methods The data of CT and MRI of 12 patients with CCRC were reviewed retrospectively.Ten patients underwent CT examination,including precontrast scan,the contrast eortieomedullary phase scan and the parenchymal phase scan(one patient without corticomedullary phase scan).Two patients underwent MR examination including precontrast T_1WI,T_2WI and enhanced T_1WI of the corticomedullary phase and the parenchymal phase.Results Four lesions located in left kidney and eight in right kidney.Maximum diameter of lesions ranged from 24 mm to 125 mm,average 56.7 ram.Homogenous density was observed in six lesions of ten on unenhanced CT scan and five lesions had homogenous enhancement on enhanced CT scan,which was due to the less incidence of necrosis,liquefaction and hemorrhage on pathologic findings.Nine Lesions showed hyperdense compared with renal medulla but the density was lower than renal cortex on the corticomedullary phase.The enhanced degree was positively correlated with microvessel density(MVD).All ten lesions became hypodense compared with renal medulla on the parenchymal phase scan.Central stellate scar was found in two big lesions and psudocapsula were observed in four lesions confirmed by pathology.Two patients underwent MRI examination.Compared with medulla,the two lesions showed hyperintense on unenhanced T_1WI and obviously hypointense on unenhaneed T_2WI.The enhancement pattern of them was similar to CT. Conclusion The imaging features of CCRC,such as homogeneity,special enhancement pattern and distinct hypointensity on T_2WI,help to differentiate CCRC from other renal tumors.
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Objective To prospectively evaluate whether DWI with mSENSE(mSENSE-DW1)can help to improve image quality and affect the calculation of lesion's ADC,compared with DWI with conventional phase encoding(conventional DWI)in patients with small HCC lesions.Methods Thirty-two patients with 47 small HCC lesions underwent single-shot spin-echo echo-planar.(SE-EPI)DWI with conventional phase encoding and mSENSE.Three b values of 300,500 and 800 s/mm~2 were used.Image quality and CNR between conventional DWI and mSENSE-DWI group were compared with different b value. Lesion's ADC were also calculated and compared.Matched-pairs Wilcoxon signed rank test and Friedman test were used to test statistical significance.Results The image quality was assessed with a five-point scale.For conventional DWI group,image quality score of 2 was assigned in 5 cases,score of 3 in 24 cases, score of 4 in remaining 3 eases with b=300 s/mm~2,score of 2 in 9 eases,score of 3 in 22 cases,score of 4 in remainingl cases with b=500 s/mm~2,score of 1 in 2 cases,score of 2 in 24 cases,score of 3 in remaining 6 cases with b=800 s/mm~2.For mSENSE-DWI group,image quality score of 3 was assigned in 4 cases,score of 4 in 25 cases,score of 5 in 3 eases with b=300 s/mm~2,score of 3 in 10 cases,score of 4 in 20 cases,score of 5 in remaining 2 cases with b=500 s/mm~2,score of 2 in 7 cases,score of 3 in 23 eases, score of 4 in remaining 2 cases with b=800 s/mm~2.Higher image quality scores were achieved at mSENSE- DWI group than conventional DWI group(Z=-5.578,-5.488,-4.796 respectively,P
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0.75).The distal branch of hepatic right/left artery were well delineated in 39 patients(scored 4),hepatic right/left artery in 23 patients(scored 3),proper hepatic artery in 4 patients(scored 2)and hepatic common artery in 1 patients(scored 1).The average score was 3.49.Fifty three cases with normal hepatic arterial anatomy and 14 cases with anomalies were accurately detected on high-resolution MRA images.Conclusion High- resolution contrast-enhanced MRA accelerated by GRAPPA could delineate the hepatic artery accurately.