• Title/Summary/Keyword: Delayed hyperenhancement imaging

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Atypical Manifestation of Primary Hepatocellular Carcinoma and Hepatic Malignancy Mimicking Lesions (원발성 간세포암의 비특이적 영상 소견 및 간암으로 오인될 수 있는 병변에 대한 영상의학적 고찰)

  • Jiyoung Yoon;So Hyun Park;Su Joa Ahn;Young Sup Shim
    • Journal of the Korean Society of Radiology
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    • v.83 no.4
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    • pp.808-829
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    • 2022
  • Hepatocellular carcinoma (HCC) can be diagnosed noninvasively on multiphasic CT and MRI based on its distinctive imaging findings. These features include arterial phase hyperenhancement and washout on portal or delayed phase images. However, radiologists face significant diagnostic challenges because some HCCs exhibit atypical imaging characteristics. In addition to many HCC-mimicking lesions, such as arterioportal shunts, combined HCC-cholangiocarcinoma, intrahepatic cholangiocarcinoma, and hemangioma present a challenge for radiologists in actual clinical practice. The ability to distinguish HCCs from mimickers on initial imaging examinations is crucial for appropriate management and treatment decisions. Therefore, this pictorial review presents the imaging findings of atypical HCCs and HCCs mimicking malignant and benign lesions and discusses important clues that may help narrow down the differential diagnosis.

Non-mass-forming Lymphoma of the Left Ventricle Mimicking Non-ischemic Cardiomyopathy on MR Imaging: A Case Report (MRI에서 비허혈성 심근병증으로 오인된 좌심실의 림프종: 증례 보고)

  • Shin, Won-Seon;Kim, Sung-Mok;Choe, Yeon-Hyeon;Hyeon, Ji-Yeon;Kim, Jung-Sun;Chang, Sung-A
    • Investigative Magnetic Resonance Imaging
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    • v.16 no.2
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    • pp.189-194
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    • 2012
  • We report a case of cardiac lymphoma in a 40-year-old man, who had a mediastinal mass which was diagnosed as sclerosing mediastinitis pathologically. The mediastinal mass caused right pulmonary arterial stenosis. The patient developed myocardial hypertrophy and echocardiography showed restrictive physiology and severely decreased left ventricle ejection fraction, 6 months later. MRI showed global left ventricular myocardial hypertrophy and diffuse late gadolinium hyperenhancement after administration of contrast material. Thus, non-ischemic cardiomyopathy was suspected on MRI. However, pathology confirmed the myocardial abnormality as lymphoma after myocardial biopsy. Because a basal part of the left ventricle and global subendocardial myocardium were not involved on contrast-enhanced delayed MRI, the MRI abnormalities could be differentiated from amyloidosis and other myocardial diseases. The peculiar non-mass forming diffuse hypertrophy pattern of cardiac lymphoma has not been known in the MRI literature.

Usefulness of contrast agent involving high gadolium content for myocardial viability assessment (심근생존능검사 시 가돌리늄 함유량이 높은 조영제의 유용성)

  • Choi, Kwan-Woo;Son, Soon-Yong;Kim, Tae-Hyung;Han, Man-Seok;Lee, Ju-Hee;Min, Jung-Whan
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.14 no.3
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    • pp.1294-1300
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    • 2013
  • The purpose of this study is to increase contrast to noise ratio(CNR) in myocardial viability test by using contrast agent which highly content gadolinium(1mmol/mL) maximizing diagnostic value. This research method that four hundred four patients were underwent the MRI scanning two hundred eighty four of them were injected commercial contrast media which have 0.5mmol/L and the rest of them were injected new contrast media(gadobutrol) which have 1mmol/mL of molarity to study the contrast difference depending on the molarity of the contrast agent signal intensities of normal ventricle and left ventricle were measured to compare and evaluate signal to noise ratio(SNR) and CNR of the images. As result, 1mmol/mL contrast agent showed higher SNR by 25.13% in myocardium and 30.74% in left ventricle. CNR was proved to be better in 1mmol/mL contrast agent by 31.29%. The results above were all statistically meaningful. Therefore, contrast agent contenting more gadolinium which was 1mmol/mL in this study, could more effectively shorten T1 relaxation time, increase the signal intensity and at the same time maximize CNR and diagnostic value. This study firstly report the usefulness of 1mmol/mL contrast agent in patients allegedly suffering cardiac diseases and it is considered to increase diagnostic value.