High hepatocyte-selective enhancement is induced by expression patterns of transporters, which may result in accumulation of gadoxetic acid in cytoplasm of tumor cells or in lumina of pseudoglands. An HCC with gadoxetic acid enhancement is characterized by bile accumulation in tumors.

Reduced Gd-EOB-DTPA uptake might be an early event of hepatocarcinogenesis, preceding portal blood flow reduction. The hepatobiliary phase of Gd-EOB-DTPA-enhanced MRI may help estimate histological grading, although difficulties exist in differentiating HCCs from DNs.

Double arterial phase imaging is recommended to improve detection of hypervascular HCCs and reduce false-positive lesions.

The purpose of this study was to clarify ultrasound (US) evaluation of microcalcifications and determine whether the calcifications seen in US scans can reliably predict malignant thyroid tumors. Diagnostic accuracy of microcalcification and other various signs seen in US scans for predicting malignancy was evaluated prospectively in 259 pathologically verified thyroid nodules. Sonographic and pathologic correlation of calcifications was performed on 69 of 99 surgically removed nodules. Pathologic studies revealed that hyperechoic areas with acoustic shadowing represented mostly amorphous dense calcifications and sometimes microcalcifications, but small particles without acoustic shadowing mainly reflected microcalcifications and sometimes large amount of fibrous bands and condensed colloids. Of the various sonographic signs, microcalcification showed the highest accuracy (76%), specificity (93%), and positive predictive value (70%) for malignancy as a single sonographic sign, but its sensitivity (36%) was poor. Although sonographic microcalcification showed relatively high specificity, the accuracy of this finding for malignancy was insufficient.

Multi-detector row CT scanning of patients with gastric cancer gave 93% accuracy in the assessment of serosal invasion in patients with gastric cancer.

To investigate the potential of gadolinium (Gd)-ethoxybenzyl (EOB)-diethylenetriamine-pentaacetic acid (DTPA) for evaluating liver function, chemically induced hepatitis animal models were studied. The rats in group 1 underwent intraperitoneal administration of 2.0 ml/kg and those in group 2 underwent intraperitoneal administration of .5 ml/kg of 50% (V/V) carbon tetrachloride (CCl4) solution. The rats in group 3 served as controls. For rats of each group, the signal intensity of the liver was measured on T1-weighted spin-echo MR images acquired before and until 60 minutes after an intravenous injection of Gd-EOB-DTPA. The remaining rats in each group underwent indocyanine green test, serologic examination, or measurement of prothrombin time. Liver enhancement was compared with results of the other examinations. The degree of liver enhancement with Gd-EOB-DTPA was decreased and the washout of contrast was prolonged in the CCl4-administered groups. In this animal model, both hepatic dysfunction and liver enhancement were dose-dependent. MRI with Gd-EOB-DTPA has the potential to evaluate hepatic function.

This study assessed the utility of CT perfusion for quantitative assessment of liver function and fibrosis. Tissue blood flow (TBF), tissue blood volume (TBV), mean transit time (MTT) and hepatic arterial fraction (HAF) were measured with CT perfusion using the deconvolution algorithm in 38 patients with chronic liver diseases and 10 patients without liver disease. Using Child-Pugh classification, 21 patients were classified as Child A, 10 as Child B, and 7 as Child C. In 20 patients, the degree of fibrosis was quantitated in surgicallyresected specimens and compared with the perfusion parameters. The mean TBF, TBV, MTT and HAF of patients without liver disease were 103.9±18 ml/min/100 g, 12.5±2.0 ml/ 100 g, 11.1±1.6 sec and 18.4±5.6%, respectively (±SD). The mean TBF of patients with Child A, B and C were 95.1±24, 86.7±29 and 75.5±6.5 ml/min/100 g, respectively. TBF tended to decrease with the severity of chronic liver disease. The mean HAF of patients with Child A, B and C were 18.6±8.3, 29.8±11.2 and 40.2±11.1%, respectively. HAF of patients without liver disease was significantly different from those of Child B and C (p<0.05, each). However, there were no significant differences in TBV and MTT between each groups. HAF correlated significantly with the degree of fibrosis (R 2 =0.588, p<0.05). Our results showed that parameters of CT perfusion correlated significantly with the severity of liver fibrosis and cirrhosis. Quantitative measurement of hepatic tissue blood flow by CT perfusion is useful for evaluation of the severity of disease and fibrotic change.

Among body size parameters, LBW exhibited the strongest correlation with aortic and hepatic enhancement, especially in women.