Double Contrast Mk Fok The Detection And Characterisation Of Hepatocellolar Carcinoma In The Cirrhotic Liver

-Introduction: Hepatocellular carcinoma (HCC) develops against a background of cirrhosis by a multi-step dedifferentiation process from regenerative nodules to dysplastic nodules to HCC. Liver transplantation provides the most effective treatment for HCC providing the diagnosis is made at an early stage, but because the liver is structurally abnormal, HCC is often difficult to detect and distinguish from benign nodules. SPIO-enhanced MRI [l] and dynamic Gd-DTPA enhanced MRI [2,3] have been shown to improve the detection and characterisation of HCC. In the only clinical study to combine an iron colloid preparation and Gd-DTPA in the investigation of HCC, images obtained several minutes after injection of Gd-DTPA and iron colloid provided a significant improvement in characterisation but no improvement in detection [4]. Combining SPIO with rapid sequential imaging alter Gd-DTPA may further improve the diagnosis of HCC. The purpose of this study therefore was to investigate the role of double contrast MR (DCMR) with SPIO and bolus injection of Gd-DTPA in the detection and character&&on of HCC in the cirrhotic liver. for dysplastic nodules compared with HCC ~O.OlXtable 6). For dysplastic nodules, maximum PE occurred on images obtained 120 sets after Gd and for HCC on images obtained at 80 sets; there was no significant difference in PE between the two lesions.