MRI as a Preoperative Single Imaging Test in Hepatocellular Carcinoma / 한국간담췌외과학회지

ABSTRACT

BACKGROUNDS/AIMS: MRI performed preoperatively for Hepatocellular Carcinoma(HCC) not only detects and provides information on the tumor characteristics but can also be used as a noninvasive method via MR-angiogram. MR-angiogram can reconstruct the tumor and its relation to vessels in three dimension. Therefore, it has the advantage of presenting the exact relations of the tumor and the intrahepatic vessels. Recently, preoperative imaging in HCC has become more complex. The invasive angiography is at the center of these various, complex tests and there is a tendency for unnecessary, repeated testing. The cost of these complex tests is hard to ignore. The purpose of this study was to compare single preoperative MRI with other tests and weigh the advantages. METHODS: The subjects were thirty-nine patients who underwent surgery for HCC from November, 1997 through October, 1998. Ten of these patients who had HCC with the diameter of less than 5cm, were evaluated with MRI and when necessary MR angiogram only. The control group were eleven patients with tumor of the same size as above but whom were evaluated with abdominal CT + Hepatic angiogram + Transcatheter arterial chemoembolization(TACE) + lipodol CT, abdominal CT + Hepatic angiogram + CT - AP + TACE + lipodol CT or abdominal CT + Hepatic angiogram + CT - AP + TACE during the identical period. RESULTS: The average cost of preoperative testing was lowest with MRI only. There were no deaths in either group and complication occured in one case of each group. Comparison of the duration of admission between these groups showed a statistically significant difference(p=0.003). The MRI only group with an average of 22.5 days and the control group of 30.8 days. This was due to shortening of the preoperative testing time. Another point worth noting is that patients who underwent MRI alone complained less of discomfort. CONCLUSION: MRI alone group was comparable to control group in providing of preoperative anatomical information. Not performing angiography did not increase risks technically during operation. The authors suggest that MRI as the single preoperative imaging test can be in alternative to the various preoperative imaging test.