Characterization of Cirrhotic Nodules With Gadoxetic Acid-Enhanced Magnetic Resonance Imaging: The Efficacy of Hepatocyte-Phase Imaging

Purpose: To evaluate the efficacy of hepatocyte-phase imaging (HP) in characterization of focal hepatic lesions in cirrhotic liver using gadoxetic acid-enhanced magnetic resonance imaging (MRI). Methods: A total of 66 nodules of 38 patients with liver cirrhosis undergoing gadoxetic acid-enhanced MRI were prospectively enrolled in this study. The histological examination revealed 15 dysplastic nodules (DNs), 7 well-differentiated hepatocellular carcinomas (wHCCs), and 44 moderately differentiated HCCs (mHCCs). Two imaging sets (Set A without HP, Set B with HP) were prepared to evaluate the efficacy of HP in lesion characterization. Results: The mean enhancement ratios (ERs) of mHCC were significantly increased in arterial phase followed by a subsequent decreased in hepatocyte phases. The mean ERs of wHCC were increased in dynamic study and followed by a plateau in the hepatocyte phase. The mean ERs of DNs were increased in dynamic study and hepatocyte phase. The mean liver-to-lesion contrasts of mHCCs were increased in arterial phase and HP (P < 0.05). wHCCs were only increased in HP (P < 0.05). DNs showed no significant difference in any phase (P > 0.05). There were seven additional HCCs that were detected in HP using imaging Set B compared to Set A. The diagnostic performance of Set B was significantly higher than that of Set A (P = 0.016). Conclusion: The combination of gadoxetic acid-enhanced dynamic study and hepatocyte-phase T1WI may provide better diagnostic performance than only dynamic study in characterization of focal lesions in cirrhotic liver.