Implementation of a rapid inversion-prepared dual-contrast gradient echo sequence for quantitative dynamic contrast-enhanced magnetic resonance imaging of the human prostate

The first step in quantitative pharmacokinetic modeling is to determine the arterial input function (AIF) by deriving the contrast medium (CM) concentration from an appropriate imaging sequence by monitoring changes in either the amplitude or the phase signal of an accommodative artery. The bolus passage is best detected on T2- or T2*-weighted images, while extravasation is best assessed on T1-weighted images. Here, an imaging sequence is used that employs a parallel acquisition technique for the interleaved acquisition of an inversion-prepared T1-weighted image and a T1/T2*-mixed-weighted image for determination of the AIF.

The sequence was applied in six patients with prostate cancer. A method is presented for quantifying the AIF derived from the signal intensity-time courses of both the T1/T2*-mixed-weighted and the T1-weighted image. Furthermore, in some patients the signal intensity-time course of the T1-weighted image exhibits flow-induced signal modulations. To reduce the effect of this flow-related signal enhancement the corresponding phase information was used.

The sequence presented here has the potential to improve the quantification of the AIF at all time points and pharmacokinetic modeling of the CM dynamics of the prostate.     

Correcting the effects of background microcirculation in the measurement of arterial input functions using dynamic susceptibility contrast MRI of the brain

In dynamic susceptibility contrast MRI, the shape of the arterial input function (AIF) is commonly obtained in the near vicinity of the middle cerebral artery (MCA). However, the tissue regions where the AIF is sampled also have significant perfusion, which contributes to T(2)* changes. We investigate whether correction of this effect will introduce significant changes in the measurement of the AIF and, subsequently, the assessment of the mean transit time (MTT). Clinical dynamic susceptibility data from 13 patients with brain tumors were analyzed. Patients received either single or double doses of Magnevist followed by a saline flush through a power injector. In the correction procedure, DeltaR(2)* was sampled in a region of gray matter approximately 1-2 cm away from the MCA and then subtracted from the DeltaR(2)* sampled in the immediate vicinity of the MCA. We demonstrate that in the brain, this correction of DeltaR(2)* due to tissue perfusion leads to a narrower width of the AIF curve obtained with DeltaR(2)* (mean+/-S.D.=7.3+/-2.0 and 6.4+/-1.7 s, before and after correction, respectively, P<.001 using a two-tailed paired t-test). Furthermore, the peak of the AIF also moved to a slightly earlier time relative to the time of arrival (mean+/-S.D.=4.7+/-0.9 and 4.3+/-0.8 s, before and after correction, with P<.001). With the use of the corrected AIF, the measured MTT had increased values in areas of both gray and white matter.     

Hemorrhagic cerebral metastases from thyroid cancer on T2*-weighted gradient echo MRI

We report a case of multiple hemorrhagic cerebral metastases from papillary thyroid cancer, with reference to T(2)*-weighted gradient echo (GRE) magnetic resonance imaging (MRI). Small metastatic nodules were recognized as round nodules with signal loss on T(2)*-weighted GRE MRI, and were more pronounced compared with other sequences. Lesions were later confirmed as hemorrhagic on T(1)- and T(2)-weighted MRI. T(2)*-weighted GRE MRI was a sensitive tool for early detection of metastases displaying hemorrhagic changes.     

Relaxivity of Gd-based contrast agents on X nuclei with long intrinsic relaxation times in aqueous solutions

The relaxivity of commercially available gadolinium (Gd)-based contrast agents was studied for X-nuclei resonances with long intrinsic relaxation times ranging from 6 s to several hundred seconds. Omniscan in pure 13C formic acid had a relaxivity of 2.9 mM(-1) s(-1), whereas its relaxivity on glutamate C1 and C5 in aqueous solution was approximately 0.5 mM(-1) s(-1). Both relaxivities allow the preparation of solutions with a predetermined short T1 and suggest that in vitro substantial sensitivity gains in their measurement can be achieved. 6Li has a long intrinsic relaxation time, on the order of several minutes, which was strongly affected by the contrast agents. Relaxivity ranged from approximately 0.1 mM(-1) s(-1) for Omniscan to 0.3 for Magnevist, whereas the relaxivity of Gd-DOTP was at 11 mM(-1) s(-1), which is two orders of magnitude higher. Overall, these experiments suggest that the presence of 0.1- to 10-microM contrast agents should be detectable, provided sufficient sensitivity is available, such as that afforded by hyperpolarization, recently introduced to in vivo imaging.     

新型Gd基T2造影剂的制备和应用

设计并合成了结构为TPP-Lys（Acp-DOTA-Gd）-COOH（简称Gd-DOTA-TPP）的小分子磁共振探针,通过电转染的方式用探针标记人源脐带间充质干细胞（hMSCs）.11.7 T磁共振成像（MRI）扫描结果表明,Gd-DOTA-TPP标记的hMSCs在细胞内Gd含量为9×10⁹ Gd/cell时,T₂加权信号强度即可低至背景信号强度,呈现较强暗信号.将Gd-DOTA-TPP标记的hMSCs移植入小鼠脑室,可明显提高移植干细胞在MRI设备上的检测灵敏度,检测限可低至10³个细胞.     

Superparamagnetic iron oxide-enhanced MR imaging for early and late radiation-induced hepatic injuries

Superparamagnetic iron oxide (SPIO)-enhanced MRI was performed in twenty-one patients undergoing proton-beam radiotherapy for hepatocellular carcinomas. Patients were divided into two groups: early and late phase hepatic injuries. Each group was investigated 3 to 9 weeks and 4 to 65 months after the start of irradiation, respectively. T(1)-weighted, T(2)-weighted, and T(2)*-weighted images were obtained before and after SPIO administration. In all postcontrast sequences in the early phase, irradiated livers demonstrated relatively higher intensity than nonirradiated livers and the radiation-to-liver contrast-to-noise ratio (C/N) was improved. Postcontrast T(2)*-weighted images showed the highest C/N. In the late phase, the irradiated areas showed high intensity on T(2)-weighted images and low intensity on T(1)-weighted images without SPIO, while high intensity on T(1)-weighted images with SPIO. The C/N increased with SPIO in all sequences and postcontrast T(2)-weighted images showed the highest C/N in the late phase. SPIO-enhanced MRI is useful to evaluate this entity both in the early and late phase of clinical studies.     

Investigation of sandwiched gadolinium (III) complexes with tungstosilicates as potential MRI contrast agents

Two gadolinium-sandwiched complexes with tungstosilicates, K(13)[Gd(SiW(11)O(39))(2)] (Gd(SiW(11))(2)) and K(11)H(6)[Gd(3)O(3)(SiW(9)O(34))(2)] (Gd(3)(SiW(9))(2)), have been investigated by in vitro and in vivo experiments as potential contrast agents for magnetic resonance imaging (MRI). T(1)-relaxivity of Gd(SiW(11))(2)was 6.59 mM(-1).s(-1) in aqueous solution and 6.85 mM(-1).s(-1) in 0.725 mmol.L(-1) bovine serum albumin solution at 25 degrees C and 9.39 T, respectively. The corresponding T(1)-relaxivity of Gd(3)(SiW(9))(2) was 12.6 and 19.3 mM(-1).s(-1) per Gd, respectively. MRI for Sprague-Dawley rats showed longer and more remarkable enhancement in rat liver after i.v. injection of these two complexes: 39.4 +/- 3.9% and 57.4 +/- 11.6% within the first 30 min after injection, 31.2 +/- 2.6% and 39.9 +/- 7.6% in the next 60 min for Gd(SiW(11))(2) and Gd(3)(SiW(9))(2) at doses of 0.081 and 0.084 mmol Gd/kg, respectively. Our preliminary in vitro and in vivo study indicates that Gd(SiW(11))(2) and Gd(3)(SiW(9))(2) are favorable candidates for hepatic contrast agents for MRI. However, the two complexes exhibit higher acute toxicity and need to be modified and studied further before clinical use.     

Observation of rat hind limb skeletal muscle during arterial occlusion and reperfusion by 31P MRS and 1H MRI

31P NMR spectra and 1H MR T1- and T2-weighted spin-echo images were concurrently observed in rat hind limb during arterial occlusion and following reperfusion. With arterial occlusion, phosphocreatine level decreased and inorganic phosphate (Pi) level increased in 31P NMR spectra. Intracellular pH's dropped as a function of time. Beta-ATP started to decrease in three hours. In six hours after the occlusion, any peaks other than Pi were scarcely detected. The signal intensities in the 1H MR images increased homogeneously in both T1- and T2-weighted conditions, but the changes were more profound with T2-weighted images. After the release of the arterial occlusion, the 31P NMR spectra recovered to the preischemic state in several hours. The 1H MR images during reperfusion showed characteristic heterogenous pattern. The signal intensities in the anterior tibial muscle and the gastrocnemius muscle remained high in T1-weighted condition and the intensities further increased in T2-weighted condition, while those in other parts returned to the preischemic level. These changes were found to be irreversible even 12 hr after the release. The high signal intensities suggested the increase of water in the extracellular compartment induced by so-called reperfusion injury. Multinuclear analysis using in vivo NMR was valuable to consecutively detect time-dependent and location-specific response in skeletal muscle during ischemia and reperfusion.     

Utilization of the nephrectomized mouse for determining threshold effects of MRI contrast agents

The tissue concentration of an extravascularly distributed MRI contrast agent required to achieve a 20% change in the MRI signal intensity (SI) of skeletal muscle was determined using radiolabeled gadoteridol administered to nephrectomized mice. This minimal change in the quantified SI was reliably detected qualitatively in the MR muscle images. MR images of muscle were acquired following each intravenous injection of six sequential doses of 0.8 micromol of 153Gd-labeled gadoteridol. A 2.0 T imaging spectrometer and a T1-weighted spin-echo pulse sequence were used to acquire the MR images. After imaging, the injected 153Gd in muscle was measured, and the 153Gd assay results were used to determine the gadoteridol concentration in muscle following each injection. The muscle concentrations of gadoteridol were then correlated to the quantified enhanced MR SI of muscle. Using the 20% factor, it was concluded that the amount of gadoteridol necessary to achieve a reliable change in the SI of muscle was 33+/-10 nmol/g-skeletal muscle.     

Monitoring redox-sensitive paramagnetic contrast agent by EPRI, OMRI and MRI

A comparative study of tissue redox-status imaging using commonly used redox sensitive nitroxides has been carried out using electron paramagnetic resonance imaging (EPRI), Overhauser magnetic resonance imaging (OMRI) and conventional T(1)-weighted magnetic resonance imaging, MRI. Imaging studies using phantoms of different nitroxides at different concentration levels showed that EPRI and OMRI sensitivities were found to be linearly dependent on line width of nitroxides up to 2 mM, and the enhancement in MRI intensity was linear up to 5 mM. The sensitivity and resolution of EPRI and OMRI images depended significantly on the line width of the nitroxides whereas the MRI images were almost independent of EPR line width. Reduction of the paramagnetic 3-carbamoyl-2,2,5,5-tetramethylpyrrolidine-1-oxyl (3CP) by ascorbic acid (AsA) to the diamagnetic by hydroxylamine was monitored from a sequence of temporal images, acquired using the three imaging modalities. The decay rates determined by all the three modalities were found to be similar. However the results suggest that T(1)-weighted MRI can monitor the redox status, in addition to providing detailed anatomical structure in a short time. Therefore, a combination of MRI with nitroxides as metabolically responsive contrast agents can be a useful technique for the in vivo imaging probing tissue redox status.     

Video camera and light system for application in magnetic resonance scanners

The direct observation and simultaneous recording of subject behavior, e.g. facial movements, during MR imaging is necessary for a variety of functional imaging studies involving phenomena such as emotions, humor, mood, etc. Such observation is also valuable for the monitoring of very ill or young patients. We describe a color video camera and light system which works within the functioning scanner. The camera acquires high resolution video sequences during conventional T(1)-weighted and functional T(2)*-weighted imaging. When fixed to the head coil artefacts during the MRI-acquisition were insignificant. The video allows observation of the face detailed enough to permit FACS scoring of facial expressions. We therefore propose that it can be applied for a wide variety of studies needing visual feedback of subject behavior.     

Multicontrast multiecho FLASH MRI for targeting the subthalamic nucleus

The subthalamic nucleus (STN) is one of the most common stimulation targets for treating Parkinson's disease using deep brain stimulation (DBS). This procedure requires precise placement of the stimulating electrode. Common practice of DBS implantation utilizes microelectrode recording to locate the sites with the correct electrical response after an initial location estimate based on a universal human brain atlas that is linearly scaled to the patient's anatomy as seen on the preoperative images. However, this often results in prolonged surgical time and possible surgical complications since the small-sized STN is difficult to visualize on conventional magnetic resonance (MR) images and its intersubject variability is not sufficiently considered in the atlas customization. This paper proposes a multicontrast, multiecho MR imaging (MRI) method that directly delineates the STN and other basal ganglia structures through five co-registered image contrasts (T1-weighted navigation image, R2 map, susceptibility-weighted imaging (phase, magnitude and fusion image)) obtained within a clinically acceptable time. The image protocol was optimized through both simulation and in vivo experiments to obtain the best image quality. Taking advantage of the multiple echoes and high readout bandwidths, no interimage registration is required since all images are produced in one acquisition, and image distortion and chemical shift are reduced. This MRI protocol is expected to mitigate some of the shortcomings of the state-of-the-art DBS implantation methods.     

The gadolinium complexes with polyoxometalates as potential MRI contrast agents

The two gadolinium (Gd) polyoxometalates, K(15)[Gd(BW(11)O(39))(2)] [Gd(BW(11))(2)] and K(17)[Gd(CuW(11)O(39))(2)] [Gd(CuW(11))(2)] have been evaluated by in vivo and in vitro experiments as the candidates of potential tissue-specific magnetic resonance imaging (MRI) contrast agents. T(1) relaxivities of 17.12 mM(-1) x s(-1) for Gd(BW(11))(2) and 19.95 mM(-1) x s(-1) for Gd(CuW(11))(2) (400 MHz, 25 degrees C) were much higher than that of the commercial MRI contrast agent (GdDTPA). Their relaxivities in bovine serum albumin and human serum transferrin solutions were also reported. After administration of Gd(BW(11))(2) and Gd(CuW(11))(2) to Wistar rats, MRI showed longer and remarkable enhancement in rat liver and favorable renal excretion capability. The signal intensity increased by 37.63+/-3.45% for the liver during the whole imaging period (100 min) and by 61.47+/-10.03% for kidney within 5-40 min after injection at 40+/-1-micromol x kg(-1) dose for Gd(CuW(11))(2), and Gd(BW(11))(2) induced 50.44+/-3.51% enhancement in the liver in 5-50-min range and 61.47+/-10.03% enhancement for kidney within 5-40 min after injection at 39+/-4 micromol x kg(-1) dose. In vitro and in vivo study showed that Gd(BW(11))(2) and Gd(CuW(11))(2) are favorable candidates as tissue-specific contrast agents for MRI.     

Depth and orientational dependencies of MRI T(2) and T(1ρ) sensitivities towards trypsin degradation and Gd-DTPA(2-) presence in articular cartilage at microscopic resolution

Depth and orientational dependencies of microscopic magnetic resonance imaging (MRI) T(2) and T(1ρ) sensitivities were studied in native and trypsin-degraded articular cartilage before and after being soaked in 1 mM Gd-DTPA(2-) solution. When the cartilage surface was perpendicular to B(0), a typical laminar appearance was visible in T(2)-weighted images but not in T(1ρ)-weighted images, especially when the spin-lock field was high (2 kHz). At the magic angle (55°) orientation, neither T(2)- nor T(1ρ)-weighted image had a laminar appearance. Trypsin degradation caused a depth- and orientational-dependent T(2) increase (4%-64%) and a more uniform T(1ρ) increase at a sufficiently high spin-lock field (55%-81%). The presence of the Gd ions caused both T(2) and T(1ρ) to decrease significantly in the degraded tissue (6%-38% and 44%-49%, respectively) but less notably in the native tissue (5%-10% and 16%-28%, respectively). A quantity Sensitivity was introduced that combined both the percentage change and the absolute change in the relaxation analysis. An MRI experimental protocol based on two T(1ρ) measurements (without and with the presence of the Gd ions) was proposed to be a new imaging marker for cartilage degradation.     

Measurement and automatic correction of high-order B0 inhomogeneity in the rat brain at 11.7 Tesla

In vivo B(0) inhomogeneity in the rat brain at 11.7 Tesla was measured and decomposed up to the fourth-order spherical harmonic terms using an automatic slice shimming routine derived from the FLATNESS method. In vivo shimming of horizontal slices showed that significant improvement in the T(2)*-weighted echo-planar imaging was achieved after correction of all first-, second- and third-order in-slice shims. For localized proton spectroscopy, reproducible, high quality data were obtained after correcting all first- and second-order shims. The measured high-order in vivo B(0) inhomogeneity in terms of spherical harmonic terms should provide a useful guide for designing shims to meet in vivo requirements.     

The detection limit of a Gd3+-based T1 agent is substantially reduced when targeted to a protein microdomain

Simple low molecular weight (MW) chelates of Gd(3+) such as those currently used in clinical MRI are considered too insensitive for most molecular imaging applications. Here, we evaluated the detection limit (DL) of a molecularly targeted low MW Gd(3+)-based T(1) agent in a model where the receptor concentration was precisely known. The data demonstrate that receptors clustered together to form a microdomain of high local concentration can be imaged successfully even when the bulk concentration of the receptor is quite low. A GdDO3A-peptide identified by phage display to target the anti-FLAG antibody was synthesized, purified and characterized. T(1-)weighted MR images were compared with the agent bound to antibody in bulk solution and with the agent bound to the antibody localized on agarose beads. Fluorescence competition binding assays show that the agent has a high binding affinity (K(D)=150 nM) for the antibody, while the fully bound relaxivity of the GdDO3A-peptide/anti-FLAG antibody in solution was a relatively modest 17 mM(-1) s(-1). The agent/antibody complex was MR silent at concentrations below approximately 9 microM but was detectable down to 4 microM bulk concentrations when presented to antibody clustered together on the surface of agarose beads. These results provided an estimate of the DLs for other T(1)-based agents with higher fully bound relaxivities or multimeric structures bound to clustered receptor molecules. The results demonstrate that the sensitivity of molecularly targeted contrast agents depends on the local microdomain concentration of the target protein and the molecular relaxivity of the bound complex. A model is presented, which predicts that for a molecularly targeted agent consisting of a single Gd(3+) complex with bound relaxivity of 100 mM(-1) s(-1) or, more reasonably, four tethered Gd(3+) complexes each having a bound relaxivity of 25 mM(-1) s(-1), the DL of a protein microdomain is approximately 690 nM at 9.4 T. These experimental and extrapolated DLs are both well below current literature estimates and suggests that detection of low MW molecularly targeted T(1) agents is not an unrealistic goal.     

Liver imaging at 1.5 tesla: pulse sequence optimization based on improved measurement of tissue relaxation times

In order to predict the most sensitive MR imaging sequence for detecting liver metastases at 1.5 T, in vivo measurements of T1 and T2 relaxation times and proton density were obtained using multipoint techniques. Based on these measurements, two-dimensional contrast contour plots were constructed demonstrating signal intensity contrast between hepatic lesions and surrounding liver parenchyma for different pulse sequences and pulse timing parameters. The data predict that inversion recovery spin echo (IRSE) imaging should yield the greatest contrast between liver metastases and liver parenchyma at 1.5 T, followed by short tau inversion recovery (STIR) and spin-echo (SE) pulse sequences. T2-weighted SE images provided greater liver/lesion contrast than T1-weighted SE pulse sequences. Calculated T1, T2, and proton density values of the spleen were similar to those of hepatic metastatic lesions, indicating that the signal intensity of the spleen may be used as an internal standard to predict the signal intensity of hepatic metastases on T1- and T2-weighted images at 1.5 T.     

Comparison of multi-echo spiral and echo planar imaging in functional MRI

Multi-echo spiral and echo-planar (EPI) imaging sequences were compared in functional imaging experiments at 3 Tesla. Both sequence types allow calculation of the effective transversal relaxation time T(2)* and the initial signal intensity I(0). These parameters can be used in evaluation of the functional signal with respect to inflow effects and other vascular sources. Prior to functional magnetic resonance imaging (fMRI) experiments T(2)* measurements in the human brain were performed with single- and multi-echo FLASH (fast low angle shot) and compared with EPI und spiral imaging sequences. These experiments resulted in T(2)* values ranging from 42.9 to 53.8 ms in a ROI including white and gray matter and CSF in a prefrontal brain region, and allowed validation of the quantitative results of the fast single-shot techniques. In functional experiments with motor stimulation mean absolute T(2)* increases during stimulation of 1.1 +/- 0.6 ms and 1.4 +/- 0.9 ms were found with multi-echo EPI and spiral imaging, respectively, averaged over the activated pixels. In addition, absolute T(2)* values and the size of activated areas obtained with both sequences are comparable. In these investigations spiral imaging allowed higher spatial resolution due to more efficient use of available gradient performance.     

Exophytic benign tumors of the liver: appearance on MRI.

The purpose of our study was to determine the MR imaging appearance of exophytic benign liver tumors on precontrast and postgadolinium images. We reviewed our 9.5 year experience with MRI of the liver with dynamic gadolinium enhanced imaging to identify four patients with five histologically proven exophytic benign liver tumors. The histological diagnoses were cavernous hemangioma (2), focal nodular hyperplasia (FNH) (1), and hepatocellular adenoma (HCA) (2 exophytic adenomas in a patient with adenomatosis of the liver). All MRI studies were performed at 1.5 T and included: in-phase and out-of-phase T1-weighted spoiled gradient echo (SGE), T2-weighted fat-suppressed echo train spin echo, single shot T2-weighted sequences, and serial postgadolinium T1-weighted SGE sequences without and with fat-suppression. Prospective interpretations were reviewed and retrospective consensus readings of all MR images were performed assessing location, size, origin, morphology, visibility of the connection to the liver, signal characteristics on precontrast T1-weighted and T2-weighted images, and enhancement patterns on serial postgadolinium images. Three of the five tumors were pedunculated and connected to the liver by a thin stalk, which was prospectively identified in one patient. On precontrast and serial postgadolinium images, all exophytic tumors showed signal characteristics comparable to imaging features of standard intraparenchymal benign liver tumors. Our findings illustrate that the characteristic T1, T2, and postgadolinium imaging findings of these tumors permit correct identification of their liver origin despite their exophytic location, even if their connection with liver is not visualized.     

Small hepatocellular carcinomas in cirrhosis: differences in contrast enhancement effects between helical CT and MR imaging during multiphasic dynamic imaging

PURPOSE: The purpose of this study was to evaluate differences in the degrees of contrast enhancement effects of small hepatocellular carcinomas (HCCs) in patients with cirrhosis between helical computed tomography (CT) and magnetic resonance (MR) imaging during multiphasic contrast-enhanced dynamic imaging and to determine the diagnostic value of MR imaging especially in assessing hypovascular HCCs detected as hypoattenuating nodules on late-phase CT. SUBJECTS AND METHODS: This study included 64 small HCCs (<3 cm in diameter) in 40 patients with chronic hepatitis or cirrhosis who underwent multiphasic (arterial, portal and late phases) contrast-enhanced dynamic helical CT and MR imaging. The contrast enhancement patterns of each lesion in the arterial and late phases were evaluated by two radiologists experienced in liver MR imaging and categorized as one of five grades (1=hypoattenuated/hypointense; 2=slightly hypoattenuated/hypointense; 3=isoattenuated/isointense; 4=slightly hyperattenuated/hyperintense; 5=hyperattenuated/hyperintense), compared with the surrounding liver parenchyma. RESULT: Forty-three (67%) of 64 lesions showed Grade 4 (n=24) or Grade 5 (n=19) enhancement on arterial-phase CT, while 51 (80%) of 64 lesions showed Grade 4 (n=20) or Grade 5 (n=31) enhancement on arterial-phase MR imaging, indicating hypervascular HCCs. The grading score of hypervascular HCCs on arterial-phase MR imaging (mean: 4.61) was significantly (P<.01) higher than that for hypervascular HCCs on arterial-phase CT (mean: 4.20), showing better detection of the hypervascularity (arterial enhancement) of the lesion on arterial-phase MR imaging. Regarding hypovascular HCCs, all (100%) of 21 hypovascular HCCs on CT showed Grade 1 (n=10) or Grade 2 (n=11) enhancement on late-phase CT, seen as hypoattenuation. In contrast, 8 (62%) of 13 hypovascular HCCs on MR imaging showed Grade 1 (n=1) or Grade 2 (n=7) enhancement on late-phase MR imaging, seen as hypointensity. Grading scores of hypovascular HCCs on late-phase images were significantly (P<.001) lower on CT than on MR imaging (mean score: 1.52 vs. 2.31), indicating better washout effects for hypovascular HCCs on late-phase CT. CONCLUSION: The washout effects for small HCCs on late-phase MR imaging were inferior to those for small HCCs on late-phase CT. Especially, hypovascular HCCs demonstrated as hypoattenuating nodules on late-phase CT were often not seen on late-phase MR imaging, requiring careful evaluation of other sequences, including unenhanced T(1)-weighted and T(2)-weighted MR images.