Focal liver lesions: Practical magnetic resonance imaging approach

Nowadays, it is difficult to overestimate the role of cross-sectional imaging in the diagnosis of focal and diffuse liver diseases. In magnetic resonance imaging (MRI) there is a unique opportunity to use hepatospecific contrast agents compared with other visualization techniques. Gadoxetic acid is a hepatospecific magnetic resonance contrast agent which has the extracellular contrast agent properties and hepatotropic property. About half of the administered dose of gadoxetic acid enters into functioning hepatocytes through cell membrane transporters and then is excreted into the bile ducts and sinusoidal space. The obtained hepatobiliary phase provides information about the structural features of the focal liver lesions, improving their detection and differential diagnosis. In addition it allows to assess the anatomical and functional conditions of the hepatobiliary system. This article describes clinical applications of MRI with gadoxetic acid and its benefits, visualization principles of different focal liver lesions in hepatobiliary phase and features of the obtained images.

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Magnetic Resonance Imaging of Focal Liver Lesions

Investigative Radiology ◽

10.1097/00004424-199611000-00004 ◽

1996 ◽

Vol 31 (11) ◽

pp. 696-708 ◽

Cited By ~ 69

Author(s):

THOMAS J. VOGL ◽

RENATE HAMMERSTINGL ◽

WOLFRAM SCHWARZ ◽

SHERKO KÜMMEL ◽

PETRA K. MÜLLER ◽

...

Keyword(s):

Magnetic Resonance Imaging ◽

Magnetic Resonance ◽

Focal Liver Lesions ◽

Liver Lesions ◽

Resonance Imaging

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Late Gadolinium Hyperintensity of Suspected Colorectal Liver Metastases on Gadofosveset-Enhanced Magnetic Resonance Imaging: A Predictor of Benignity and a Potential Problem-Solving Tool

Canadian Association of Radiologists Journal ◽

10.1016/j.carj.2019.03.006 ◽

2019 ◽

Vol 70 (3) ◽

pp. 239-245

Author(s):

Helen M.C. Cheung ◽

Paul J. Karanicolas ◽

Natalie Coburn ◽

Calvin Law ◽

Laurent Milot

Keyword(s):

Magnetic Resonance Imaging ◽

Magnetic Resonance ◽

Contrast Agents ◽

Characteristic Curve ◽

Focal Liver Lesions ◽

Liver Lesions ◽

Resonance Imaging ◽

Operating Characteristics ◽

Benign Lesions ◽

Receiver Operating

PurposeLate gadolinium hyperintensity (LGH) is sometimes seen in colorectal liver metastasis (CRLM) and represents a significant diagnostic pitfall due to overlap with LGH in benign hemangiomas; therefore, the objective of this study was to determine the prevalence of LGH and the ability of LGH to differentiate between CRLM and benign lesions with intravascular (gadofosveset) vs extracellular contrast agents (gadobutrol).MethodsPatients with known colorectal cancer and suspected liver lesions were prospectively recruited into this institutional review board–approved, single institution study and received magnetic resonance imaging of the liver with gadofosveset and gadobutrol. The prevalence of LGH for CRLMs and solid benign lesions was determined. Receiver operating characteristics curves were determined for the presence of LGH as a predictor of benignity. The utility of LGH to differentiate between CRLM and solid benign lesions using gadofosveset vs gadobutrol was compared using the generalized estimating equation.ResultsTwenty-five patients with 131 solid focal liver lesions were recruited. The prevalence of LGH of CRLMs was 11.2% (95% confidence interval [CI]: 0.5%–21.8%) with gadofosveset vs 63.7% (95% CI: 45.7%–81.7%) with gadobutrol. The area under the receiver operating characteristic curve for the presence of LGH as a predictor of benignity was 0.86 using gadofosveset vs 0.75 using gadobutrol. Both LGH ( P = .003) and the interaction of contrast agent and LGH ( P = .003) statistically significantly differentiated CRLM from benign lesions.ConclusionLGH is more common with extracellular than with intravascular contrast agents and is statistically significantly associated with benign lesions rather than metastases.

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Diagnostic Value of Semiquantitative Analysis of Dynamic Susceptibility Contrast Magnetic Resonance Imaging with GD-EOB-DTPA in Focal Liver Lesions Characterization: A Feasibility Study

Gastroenterology Research and Practice ◽

10.1155/2015/630273 ◽

2015 ◽

Vol 2015 ◽

pp. 1-7 ◽

Cited By ~ 2

Author(s):

Davide Ippolito ◽

Maddalena Colombo ◽

Chiara Trattenero ◽

Pietro Andrea Bonaffini ◽

Cammillo Talei Franzesi ◽

...

Keyword(s):

Magnetic Resonance Imaging ◽

Magnetic Resonance ◽

Focal Liver Lesions ◽

Dynamic Susceptibility ◽

Liver Lesions ◽

Resonance Imaging ◽

Dynamic Susceptibility Contrast ◽

Contrast Enhanced ◽

Malignant Lesions ◽

Susceptibility Contrast

Purpose.To assess the diagnostic accuracy of dynamic susceptibility contrast-enhanced magnetic resonance imaging (DSCE-MRI) in differentiation between benign and malignant liver lesions by assessment of tumoral perfusion parameters.Methods Materials.Seventy-three patients with known focal liver lesions, including 45 benign (16 FNH, 27 angiomas, and 2 abscesses) and 28 malignant ones (17 metastases, 9 HCCs, and 2 cholangiocarcinoma) underwent 1.5 T MRI upper abdominal study, with standard protocol that included dynamic contrast-enhanced sequences. On dedicated workstation, time-intensity curves were determined and the following perfusion parameters were calculated: relative arterial, venous and late enhancement (RAE, RVE, RLE), maximum enhancement (ME), relative enhancement (RE), and time to peak (TTP).Results.All diagnoses were established either by histopathology or imaging follow-up. Perfusion mean values calculated in benign lesions were RAE 33.8%, RVE 66.03%, RLE 80.63%, ME 776.00%, MRE 86.27%, and TTP 146.95 sec. Corresponding perfusion values calculated in malignant lesions were RAE 22.47%, RVE 40.54%, RLE 47.52%, ME 448.78%, MRE 49.85%, and TTP 183.79 sec. Statistical difference (p<0.05) was achieved in all the perfusion parameters calculated, obtaining different cluster of perfusion kinetics between benign and malignant lesions.Conclusions.DSCE-MRI depicts kinetic differences in perfusion parameters among the different common liver lesions, related to tumour supply and microvascular characteristics.

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