Diagnostic Value of Gadoxetic Acid-Enhanced MRI for Differential Diagnosis of Rare Types of Hepatocellular Carcinoma

Purpose : The article describes a variety of liver lesions, hyperintensity in the hepatobiliary phase of gadoxetic acid-enhanced MRI and the added value of gadoxetic acid in their differential diagnosis with consideration of its pharmacokinetics. Material and methods : Gadoxetic acid-enhanced MRI scans of 19 patients with slight hyperintensity lesions in the hepatobiliary phase, were retrospectively assessed, the role of DWI in differential diagnosis of rare types of hepatocellular carcinoma (HCC) and focal nodular hyperplasia (FNH) was evaluated and the statistical analysis was performed. Results : The combination of evaluated MRI semiotics features — hyperintensity in native, arterial, portal venous and hepatobiliary phases, slight hyperintensity on DWI (b-value 800 and b-value 400 s/mm 2 ), rim enhancement (“capsule”) — enables differentiation of rare types of HCC and HCC with atypical enhancement in patients with FNH. Conclusion : MRI with hepatobiliary contrast agents in junction with DWI increases the accuracy of identification of liver lesions and allows differentiation of rare types of HCC with atypical enhancement in patients with FNH without morphological verification.