MRI features of hepatocellular carcinomas with different fibrotic stroma and their relationships with findings of delayed contrast-enhancement / 中华放射学杂志

ABSTRACT

Objective To investigate the MRI features of different fibrotic stroma of hepatocellular carcinomas (HCC) and the relationships between them and delayed contrast-enhanced MR findings. Methods Twenty eight patients were enrolled in the study who had undergone dynamic contrast-enhanced MRI scanning. MRI showed largely complete rim-like enhancement in delayed phase in all the lesions which were confirmed by surgery and pathology. Delayed-enhancement in peripheral and internal position of HCC were evaluated and the thicknesses of rim-like enhancement in delayed phase were measured by analyzing the 5 minute delayed images. Among the 28 lesions, 22 were sampled and pathologically analyzed both in peripheral and internal portion of HCC and the remaining 6 were in the internal portion only. The pathological features were observed including distributions of three fibers (elastic, collagen and reticular fibers) in the periphery and internal positions of HCC, degrees of inflammatory cells infiltration outside the capsule and in the internal portion of HCC, the blood vessels in the capsules and thicknesses of fibrous capsule. The pathological features of HCC with different degrees of delayed-enhancement were compared using χ2 test, and differences in the thicknesses of rim-like enhancement of HCC in delayed phase among different pathological features were analyzed using Chi-square test. Results (1) In the peripherypathological features the typical fibrous capsules showed in all 22 HCC. And three kinds of fibers were crisscrossed within the capsules without quantitative differences. MRI findings:statistical differences in the amounts of blood vessels in the capsule of HCC among different degrees of delayed-enhancement were found (P0.05). In addition, the statistical differences in the thicknesses of rim-like enhancement of HCC showed among different thicknesses of fibrous capsule, degrees of inflammatory cells infiltration and amounts of blood vessels (all P<0.05). (2) In the internal positionspathological features the amounts of three kinds of fibers in the internal positions were significantly lower than those in the periphery. MRI findings: the statistical differences in collagen fibers, elastic fibers, reticular fibers and the degrees of infiltration of inflammatory cells of HCC were all seen among different degrees of delayed enhancement inside tumors (all P<0.05). Conclusion The delayed MR enhancement of HCC in peripheral and internal positions showed correlation with the fibers and degrees of infiltration of inflammatory cells in the tumor.