Using a 2D multibreath-hold susceptibility-weighted imaging to visualize intratumoral hemorrhage of hepatocellular carcinoma at 3T MRI: correlation with pathology.

ABSTRACT

PURPOSE: To assess the value of 2D multibreath-hold susceptibility-weighted imaging (SWI) for visualizing intratumoral hemorrhage of hepatocellular carcinoma (HCC) and correlate with pathological results. MATERIALS AND METHODS: Fifty-eight patients with 65 HCCs underwent T1-, T2-, T2-weighted imaging and SWI. The ability to detect intratumoral hemorrhage for each imaging technique was evaluated. A radiologic-pathological correlation was performed. RESULTS: The area under the receiver operator characteristic (ROC) curve (Az value) for SWI (Az = 0.941) was significantly greater than that for T1WI (Az = 0.748) and T2WI (Az = 0.700) (P = 0.000). When compared with T2, SWI had slightly higher sensitivity and equal specificity, but the Az value was not significantly different (P = 0.768). The total number of hemorrhages detected by SWI was greatest by factors of 13.3, 6.7, and 2.2 compared to T1WI, T2WI, and T2, respectively. SWI detected more microbleeds (585 in 25 HCCs) than T1WI (13 in 5 HCCs), T2WI (66 in 11 HCCs), and T2 (238 in 21 HCCs). CONCLUSION: SWI can accurately visualize internal hemorrhages and provide valuable information regarding the internal architecture of HCC.