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

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. J. Magn. Reson. Imaging 2012;36:900–906. © 2012 Wiley Periodicals, Inc.