Breath-hold spin-echo MR imaging for evaluation of dynamic enhancement of native and treated hepatocellular carcinoma after intravenous Gd-DTPA administration.

Using a simple modification of a standard spin-echo sequence which enable acquisition of three breath-hold images in 15 s, dynamic enhancement of 30 histologically proven hepatocellular carcinomas (17 native tumors, 6 completely necrotic tumors after nonsurgical treatments, and 7 tumors with viable and necrotic portions) after intravenous injection of gadolinium-DTPA was evaluated. Native hepatocellular carcinomas and viable portions in treated nodules showed elective enhancement in images obtained 40 s after contrast injection. Contrast between these lesions and the normal liver decreased thereafter. No contrast uptake was seen in entirely necrotic nodules and necrotic portions of treated nodules. Because of the capability to demonstrate the elective arterial blood supply typical of hepatocellular carcinoma, breath-hold T1-weighted spin-echo sequence should replace conventional T1-weighted images for the evaluation of intravenously administered gadolinium-DTPA enhancement of this tumor before and after nonsurgical treatments.