Original Research Value of Delayed Hypointensity and Delayed Enhancing Rim in Magnetic Resonance Imaging Diagnosis of Small Hepatocellular Carcinoma in the Cirrhotic Liver

Purpose: To determine the diagnostic utility of delayed hypointensity and delayed enhancing rim on magnetic resonance imaging (MRI) as indicators of hepatocellular carcinoma (HCC) in arterially enhancing nodules 5 cm in the cirrhotic liver and determine the features that best predict HCC. Materials and Methods: Gadolinium-enhanced MRI stud-ies performed from January 2001 to December 2004 in patients with cirrhosis were evaluated for arterially enhancing nodules measuring 5 cm. Verification was via explant correlation, biopsy, or imaging follow-up. Sensi-tivity and specificity of diagnostic features of HCC were calculated. Features predictive of HCC were determined using the Generalized Estimating Equation approach. Results: In all, 116 arterially enhancing nodules were identified in 80 patients (<2 cm: n 79, 2–5 cm n 37). Sensitivity and specificity of delayed hypointensity for HCC measuring 5 cm, 2–5 cm, and <2 cm were 0.54 (4