Role of gadoxetic acid-enhanced liver magnetic resonance imaging in the evaluation of hepatocellular carcinoma after locoregional treatment

Figure 5 Post-trans-arterial chemoembolization follow-up magnetic resonance imaging with hepatospecific contrast agent in the same patient described in Figure 4. A: In-phase T1-weighted image; B: T2-weighted image C: High b-value diffusion weighted imaging (DWI); D: Apparent diffusion coefficient map; E: Arterial phase magnetic resonance imaging (MRI); F: Arterial phase MRI with image subtraction technique; G: Portal venous phase MRI; H: Hepatobiliary phase MRI; I: Ten-month computed tomography (CT) follow-up: arterial phase; J: Ten-month CT follow-up: delayed phase. Liver MRI shows an inhomogeneously hyperintense nodule in T1WI in its right posterior portion, coexisting with a more hyperintense area in T2WI with high signal intensity in high b-value DWI in the left anterior portion. Dynamic study showed no arterial enhancement confirmed with the subtraction technique image, absence of vascularization in the portal phase and inhomogeneous hypointensity in the hepatobiliary phase. The findings are suggestive of good treatment outcome with presence of both coagulative and colliquative necrosis and no residual disease and CT scans control after 10 mo confirmed the outcome.