Ruo Kun Li, Presenter: Nothing to Disclose

Mengsu Zeng MD, PhD, Abstract Co-Author: Nothing to Disclose

Jinwei Qiang, Abstract Co-Author: Nothing to Disclose

Shengxiang Rao MD, Abstract Co-Author: Nothing to Disclose

Lingli Chen, Abstract Co-Author: Nothing to Disclose

Yongming Dai, Abstract Co-Author: Nothing to Disclose

To investigative imaging characteristics of multistep hepatocarcinogenesis in cirrhotic livers on susceptibility-weighted imaging (SWI) and correlate with histopathologic results.

Seventy-three patients with 83 nodules in cirrhotic livers underwent hepatic MR imaging with SWI. Two radiologists reviewed MR images by consensus. Imaging characteristics of dysplastic nodules (DN), DN with malignant foci and hepatocellular carcinoma (HCC) were evaluated. Prussian blue staining was performed for semiquantification of hepatic iron content and above cirrhosis-associated nodules. 

Positive iron staining of background liver parenchyma was found in 69 of 73 patients（94.5%）and 3 HCC patients were iron-negative staining of background liver parenchyma. Nine DNs appeared as hypointensity or isointensity with pathologically confirmed similar (n=7) or slighly decreased (n=2) iron deposition compared with background liver parenchyma. SWI detected 14 of 15 DNs with malignant foci. Seven cases appeared as homogeneous hyperintensity and 1 case appeared as heterogeneous hyperintensity due to intratumoral hemorrhages. The remaining 6 cases demonstrated as nodule-in-nodule appearance with iron deposition in all background nodules, iron deposition with grade 1 in one internal HCC foci, and iron-free in 5 internal HCC foci. The remaining 50 patients with hepatic iron deposition had 55 HCC lesions. Three HCC lesions had iron deposition with grade 1 to 2 and the remaining 52 HCC lesions were pathologically iron-resistant. HCC appeared as hyperintensity compared with siderotic surrounding liver parenchyma. However, HCCs with diameter larger than 3cm usully demonstrated heterogeneous hyperintensity due to intratumoral hemorrhage. 

SWI could accurately visualize dynamic iron depletion on multistep hepatocarcinogenesis in cirrhotic livers. On SWI images, DNs appear as hypointensity due to siderosis and malignant nodules appear as hyperintensity due to iron depletion.

SWI could accurately visualize dynamic iron depletion on multistep hepatocarcinogenesis, which may be valuable for characterization of cirrhotic nodules. 

Li, R, Zeng, M, Qiang, J, Rao, S, Chen, L, Dai, Y, Susceptibility-weighted Imaging of Multistep Hepatocarcinogenesis in Cirrhotic Livers: Correlation with Histopathology.  Radiological Society of North America 2014 Scientific Assembly and Annual Meeting, - ,Chicago IL. http://archive.rsna.org/2014/14015065.html