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Radiology, Vol 187, 119-123, Copyright © 1993 by Radiological Society of North America

ARTICLES

Small hepatocellular carcinoma: MR follow-up of treatment with percutaneous ethanol injection

S Sironi, T Livraghi, E Angeli, A Vanzulli, G Villa, E Colombo, G Taccagni and A DelMaschio
Department of Radiology, Scientific Institute S. Raffaele, University Hospital, Milan, Italy.

To assess the potential role of magnetic resonance (MR) imaging in the follow-up evaluation of small hepatocellular carcinoma (HCC) treated with percutaneous ethanol injection (PEI), 31 patients with a single HCC lesion less than 3.0 cm in diameter underwent MR imaging at 0.5 T before and after treatment. Posttreatment follow-up included contrast material-enhanced computed tomography (CT) and fine-needle biopsy in all cases. The most important characteristic of the treated HCC lesions was hypointensity on T2-weighted MR images in cases (27 of 31) in which complete tumor necrosis was achieved with PEI. This feature corresponded to a nonenhanced, low-attenuation area on follow-up contrast-enhanced CT scans. Four HCCs were positive for malignant cells at 6-month fine-needle biopsy; in these lesions, residual tumor tissue was of high signal intensity on T2-weighted MR images and of high attenuation on contrast-enhanced CT scans. In each case, incomplete tumor necrosis was confirmed at pathologic examination of the surgical specimen.


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