Simultaneous detection of hepatocellular carcinoma and vessel thrombus by using SPIO-enhanced B-TFE with the T2 preparation pulse technique.

The purpose of this study was to compare between superparamagnetic iron oxide (SPIO)-enhanced three-dimensional balanced turbo field-echo (B-TFE) sequence with T2 preparation pulse (T2 prep) and T2*-weighted imaging (T2*WI) for the simultaneous detection of hepatocellular carcinoma (HCC) and vessel thrombus. For 1.5-T magnetic resonance imaging, SPIO was administered to 23 patients with a portal or venous tumor thrombus, and B-TFE with T2 prep and T2*WI were acquired. Regions of interest in the B-TFE and T2*WI were selected for the tumor, liver, tumor thrombus, and vessels. The contrasts of the HCC in the liver and the tumor thrombus in the vessels were determined from clinical image. Contrast was calculated using the mean value of the signal intensity on the HCC to the liver and tumor thrombus to vessels. The mean contrasts between HCC and the liver with the use of B-TFE and T2*WI were 0.61 ± 0.05 and 0.70 ± 0.04, respectively. The contrast of HCC to the liver was significantly higher in T2*WI than in B-TFE (p < 0.05). The mean contrasts between the tumor thrombus and vessels with the use of B-TFE and T2*WI were 0.28 ± 0.02 and 0.10 ± 0.02, respectively. The contrast of tumor thrombus in the vessels was higher in B-TFE than in T2*WI (p < 0.01). Kupffer imaging can be used to assess liver function and acquire morphological images using three-dimensional B-TFE with T2 prep. This technique would be helpful for simultaneous detection of HCC and tumor thrombus.