Fatty metamorphosis of hepatocellular carcinoma: detection with chemical shift gradient-echo MR imaging.

Abstract

Chemical shift GRE MR imaging can be used to detect fatty metamorphosis in HCC.

Signal Intensity Characteristics of Liver Masses at Hepatobiliary Phase Images of Gadoxetate-Enhanced MR (EOB-MR): Qualitative Assessment

“…Although few, however, there were several non-FNH nodules that showed high signal intensity on HBP. High signal intensity of one hypovascular hepatocellular nodule may be attributable to high signal intensity on precontrast T1-weighted image, which are sometimes observed in dysplatic nodules or early HCC, due to cooper or iron deposition [12][13][14] (Fig.2) or fatty metamorphosis [15]. Because EOB uptake have been reported to be almost constant regardless of the grade of HCC, if the precontrast signal intensity is high, that would be directly reflected on the SI on HBP [16].…”

“…In the early stages of multistep hepatocarcinogenesis [12,13], some hepatocelllar nodules including regenerative nodules (RN), dysplastic nodules (DN), early hepatocellular carcinomas (eHCC) or well differentiated hepatocellular carcinomas (wHCC), have been known to exhibit high signal intensity on T1WI, either related or unrelated to fatty metamorphosis [14][15][16][17]. Therefore, there could be a hypothesis that signal intensity before contrast administration may influence signal intensity on the postcontrast image.…”

“…To test this hypothesis, we correlated SI on HBP in groups 1 and 2, namely hypo-and hypervascular hepatocellular nodules, to the incidence of lesions exhibiting high signal intensity (H) on the precontrast THRIVE image using Spearman's rank correlation. Because fat suppression is applied to THRIVE, high signal on precontrast THRIVE indicates non-fatty component with short T1 characteristics, such as copper or iron accumulation [14][15][16]. Also correlated was to the presence of fat on CSI, namely presence of signal loss on out-of-phase images [17] as compared to in-phase images.…”

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“…There are only a few case reports in the literature. [6][7][8] Although the cause of hepatocellular carcinoma with fatty change has not been well understood, it is also considered to be related to ischemia and metabolic disorders. 6,7 In some reports, this fatty metamorphosis was more frequent in small, well-differentiated hepatocellular carcinomas; however, with increased tumor diameter and increased histological grade, the fatty changes became infrequent.…”

Adrenal MRI: Techniques and clinical applications

“…Rarely, lipid containing adrenal metastases can occur are exceptions to this rule. Both hepatocellular carcinoma (26,27) and clear cell renal cell carcinoma (28) contain intracellular lipid. Patients with these primary malignancies can develop adrenal metastases that also contains intracellular lipid and lose signal intensity on chemical shift imaging (Fig.…”