Liver mass MRI

Liver Mass Microchapters
Home
Patient Information
Overview
Historical Perspective
Classification
Pathophysiology
Causes
Differential Diagnosis
Epidemiology and Demographics
Risk Factors
Screening
Natural History, Complications and Prognosis
Diagnosis
Diagnostic Study of Choice
Evaluation of Liver Mass
Staging
History and Symptoms
Physical Examination
Laboratory Studies
Electrocardiogram
X-ray
Echocardiography and Ultrasound
CT scan
MRI
Other Imaging Findings
Other Diagnostic Studies
Treatment
Medical Therapy
Surgery
Primary Prevention
Secondary Prevention
Case Studies
Case #1
Liver mass MRI On the Web
Most recent articles
Most cited articles
Review articles
CME Programs
Powerpoint slides
Images
American Roentgen Ray Society Images of Liver mass MRI All Images X-rays Echo & Ultrasound CT Images MRI
Ongoing Trials at Clinical Trials.gov
US National Guidelines Clearinghouse
NICE Guidance
FDA on Liver mass MRI
CDC on Liver mass MRI
Liver mass MRI in the news
Blogs on Liver mass MRI
Directions to Hospitals Treating bone or soft tissue mass
Risk calculators and risk factors for Liver mass MRI

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Associate Editor(s)-in-Chief: Maria Fernanda Villarreal, M.D. [2]

Overview

On MRI, characteristic features for the diagnosis of liver mass, include: higher soft tissue contrast, lack of radiation exposure, lesion characterization by evaluation of signal intensities, improving detection of hypervascular lesions, and characterization of the dynamics of contrast uptake.

MRI

On MRI, characteristic features for the diagnosis of liver mass, include:

• Higher soft tissue contrast
• Lack of radiation exposure
• Lesion characterization by evaluation of signal intensities
• Improving detection of hypervascular lesions

• Characterization of the dynamics of contrast uptake

	Ultrasound	CT scan	MRI
Hepato cellular adenoma	Heterogeneous Hyperechoic if steatotic Anechoic center if hemorrhage	Well demarcated with peripheral enhancement Homogenous more often than heterogeneous Hypodense if steatotic Hyperdense if hemorrhagic	HNF1 α: signal lost on chemical shift; moderate arterial enhancement without persistent enhancement during delayed phase IHCA: markedly hyperintense on T2 with stronger signal peripherally; persistent enhancement in delayed phase β-Catenin: inflammatory subtype has same appearance as IHCA Noninflammatory is heterogeneous with no signal dropout on chemical shift Isointense of T1 and T2 with strong arterial enhancement and delayed washout
Hemangioma	Hyperechoic with well-defined rim and with few intranodular vessels	Discontinuous peripheral nodular enhancement Isoattenuating to aorta with progressive centripetal fill-in	T1: hypointense; discontinuous peripheral enhancement with centripetal fill-in T2: hyperintense relative to spleen
FNH	Generally isoechoic	Central scar Arterial phase shows homogenous hyperdense lesion Returns to precontrast density during portal phase that is hypo or isodense	T1: isointense or slightly hypointense. Gadolinium produces early enhancement with central scar enhancement during delayed phase T2: slightly hyperintense or isointense
NRH	Isoechoic/hyperechoic	Nonenhancing nodules, sometimes hypodense, with variable sizes (most sub-centimeter)	T1: hyperintense T2: varied intensity (hypo/iso/hyperintense)
Simple hepatic cysts (SHCs)	Anechoic Homogeneous Fluid filled Smooth margins	Well-demarcated Water-attenuated Smooth lesion without an internal structure No enhancement with contrast	T1: hypointense signal intensity T2: hyperintense signal intensity
Biliary cystadenomas (BCs)	Irregular walls Internal septations forming loculi	Heterogeneous Internal septations Irregular papillary growths Thickened cyst walls	T1: Hypointense signal intensity T2: Hyperintense signal intensity
Hydatid cysts (HCs)	May appear similar to SHC. Progress to develop Thick calcified walls Hyperechoic/hypoechoic contents. Daughter cysts in periphery.	Hypodense lesion with hypervascular pericyst wall Distinct endocyst wall Calcified walls and septa easily detected. Daughter cysts seen peripherally within mother cyst.	T1: Hypointense signal intensity of cyst contents. T2: Hyperintense signal intensity of cyst contents. Hypointense rim on T2. Daughter cysts seen peripherally within mother cyst. Collapse parasitic membranes seen as floating linear structures within cyst.