Histopathologic Analysis of Signal Intensity Patterns of Well Differentiated Hepatocellular Carcinoma and Borderline Lesions on Magnetic Resonance Imaging

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The histopathologic factors which may influence the signal intensity patterns of MRI were evaluated to clarify the causes of characteristic hyperintense pattern of well differentiated hepatocellular carcinoma and borderline lesions such as adenomatous hyperplasia on T1-weighted images of MRI.Fatty metamorphosis was proved to be one of the causes and demonstrated by using the fat saturated images. Higher sensitivity of MRI compared to CT was also demonstrated.The paramagnetic effect of copper accumulation was concluded to be insufficient to influence the MRI.Iron accumulation was suggested to be one of the causes and additional gradient echo sequences may improve the detectability of borderline lesions and may be helpful for the evaluation of histological grades.We also suggested that the increased cellularity might increase the signal intensity and pointed out the similarity between borderline lesions and benign hyperplastic lesions on both imaging and histology which supported this hypothesis.The causes of characteristic hypointence pottern of well differentiated hepatocellular carcinoma and borderline lesions on T2-weighted images were also examined histopathologically. We suggested the relative hypointense pattern of such lesions resulted from increased signal intensity of surrounding parenchyma caused by the inflammation associated with chronic hepatic disease.