Gadoxetic acid-enhanced magnetic resonance imaging (GA-MRI) provides higher sensitivity for the detection of HCCs than CT or MRI using extracellular contrast media, but may have a disadvantage in detection of portal vein thrombosis (PVT) related with decreased contrast between the portal vein and liver parenchyma during dynamic phase. For detection of PVT in patients with HCC, we demonstrated that GA-MRI was noninferior to CT for sensitivity (78.8% versus 77.7%, respectively) and was superior to CT for specificity (95.4% versus 92.4%, respectively). For characterization of the PVT as benign or malignant, the GA-MRI showed noninferior accuracy to CT (93.7% versus 92.4%).
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